ArticleBMC neurology2026
Endovascular treatment versus standard medical management in primary M3 or M4 occlusion stroke in clinical practice: the oriental-MeVO registry.
Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClinical evidence of the potential treatment benefit of endovascular treatment (EVT) for M3 occlusion of the middle cerebral artery (MCA) is sparse. This study aims to compare EVT versus standard medical management (SMM) for acute M3 and M4 occlusion stroke.
methodsThis multicenter, retrospective study collected data on patients with acute ischemic stroke from an M3 or M4 occlusion from 25 comprehensive stroke centers between 09/2019 and 09/2024. The primary endpoint was the proportion of excellent outcome (modified Rankin Scale [mRS] 0-1) at 90 days. Safety measures included symptomatic intracranial hemorrhage (sICH) within 24 h and mortality at 90 days.
resultsA total of 342 patients with M3 or M4 occlusions were enrolled in the final analysis (EVT, 170; SMM, 172). In the primary analysis, there was no significant difference in EVT cohort versus SMM cohort regarding the rates of excellent outcome (mRS 0-1, 36.5% versus 37.2%, adjusted risk ratio [aRR], 0.88 [95% CI, 0.64-1.22]; P = 0.45), overall distribution of mRS score (adjusted common odds ratio [aOR], 0.94 [95% CI, 0.69-1.26]; P = 0.66), and functional independence (mRS 0-2, 53% versus 55.2%, aRR, 0.76 [95% CI, 0.55-1.05]; P = 0.10). There was no significant difference in safety measures between EVT and SMM cohorts in terms of sICH (aRR, 1.04 [95% CI, 0.63-1.72]; P = 0.85) and 90-day mortality (aRR, 0.76 [95% CI, 0.43-1.34]; P = 0.35). Successful revascularization was correlated with excellent outcome at 90 days (aRR, 2.79 [95% CI, 1.42-5.51]; P = 0.003) in the EVT cohort.
conclusionsEVT appears to be a safe and technically feasible treatment option for primary isolated M3 and M4 occlusions with clinical outcomes similar to SMM.
trial registrationURL: www.chictr.org.cn ; Unique identifier: ChiCTR2500096954, February 10, 2025.
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