ArticleStroke (Hoboken, N.J.)2026
Endovascular Therapy Versus Nonendovascular Therapy for Acute Ischemic Stroke With Distal Medium Vessel Occlusion: A Systematic Review and Meta-Analysis.
Article in Stroke (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndovascular therapy (EVT), including mechanical thrombectomy and intraarterial thrombolysis, is increasingly applied in patients with acute ischemic stroke caused by distal medium vessel occlusions. However, its efficacy and safety in this specific population remain inconclusive.
methodsWe conducted a systematic review and meta-analysis of studies comparing EVT and non-EVT for distal medium vessel occlusion patients, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Data were extracted from PubMed, Embase, and Cochrane Library up to February 16, 2025. The primary efficacy outcomes were excellent (90-day modified Rankin Scale score, 0-1) and functional independence (90-day modified Rankin Scale score, 0-2), while safety outcomes included symptomatic intracranial hemorrhage and 90-day mortality.
resultsA total of 30 studies (4 randomized controlled trials, 23 cohort studies, 3 case-control studies) involving 9210 patients were included in the meta-analysis, with 48.2% patients receiving EVT. No significant improvement was observed in excellent outcome (odds ratio, 0.98 [95% CI, 0.89-1.07]) or functional independence (odds ratio, 0.99 [95% CI, 0.90-1.08]) in patients receiving EVT compared with non-EVT. However, EVT was associated with higher risks of symptomatic intracranial hemorrhage (odds ratio, 1.79 [95% CI, 1.45-2.20]) and mortality (odds ratio, 1.40 [95% CI, 1.21-1.63]). Subgroup analysis revealed that patients with medium anterior circulation occlusions achieved higher odds of efficacy outcomes, while those with posterior circulation occlusions experienced higher risks of symptomatic intracranial hemorrhage and mortality and lower odds of efficacy outcomes.
conclusionsEVT demonstrates significant efficacy in patients with medium anterior circulation occlusions (M2, A1) without additional safety risks. However, its benefit in distal anterior circulation occlusions remains uncertain, and EVT in posterior circulation occlusions (P1, P2, P3) is associated with higher risks and lower efficacy assessed by the modified Rankin Scale. Further randomized controlled trials focusing on distal and anterior cerebral artery occlusions are warranted to clarify these findings. The conclusions were mainly based on observational studies. REGISTRATION: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42025643022.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.