EVT of MDVO Does Not Improve Outcomes

Background: Endovascular treatment (EVT) of ischemic stroke involving occlusion of the terminal internal carotid artery, M1 segment of the MCA and the basilar artery is associated with efficacy and reasonable safety and improves survival rates and functional outcomes. A smaller number of strokes occur related to occlusions of medium to distal arteries (MDVO)—the M2-MCA, M3-MCA, M4-MCA, ACA, or PCA wherein the optimal treatment specifically including EVT is less clear. Objective: To study the efficacy and safety of EVT for strokes related to MDVO. Design: Systematic review and meta-analysis. Methods: 3 large medical databases were searched from inception through February 2025 for RCTs and observational studies comparing EVT plus baseline medical therapy (BMT) versus BMT alone for strokes related to MDVO. Eventually, 38 studies, mostly observational trials, were entered, comprising 4584 EVT patients and 5468 BMT-treated patients. Mean age was 72 years, and 54% were male. Results: Patie more...