Current Trials on Endovascular Therapy for Medium Vessel Occlusions

Recent trials have examined the efficacy and safety of endovascular therapy for medium vessel occlusions (MEVOs) in stroke cases, challenging previous norms that focused primarily on large vessel occlusions. The DISTAL trial, involving 540 patients, reported no significant difference in functional status at 90 days between patients receiving thrombectomy and those who did not, alongside a concerning increase in symptomatic intracranial hemorrhage. Similarly, the ESCAPE-MEVO trial showed comparable results, highlighting a higher mortality rate in thrombectomy patients. These findings suggest that thrombectomy for MEVOs may not offer clear benefits and warrant more cautious application in clinical practice despite the common consideration for such treatments at thrombectomy-capable centers.