Trial of Endovascular Therapy for Mild Stroke with Large-Vessel Occlusion.

Endovascular therapy plus medical management improved 90-day excellent functional outcomes in Chinese patients with mild anterior-circulation large-vessel occlusion stroke, reaching 69.4% versus 50.0%.

• Why it matters: The benefit of endovascular therapy for mild acute ischemic stroke due to anterior-circulation large-vessel occlusion is uncertain, especially when perfusion imaging suggests substantial at-risk tissue.
• What they did: In a multicenter, open-label randomized trial in China, patients with NIHSS <6 and small infarct core with large perfusion mismatch were assigned to endovascular therapy plus medical management or medical management alone within 24 hours.
• The result: At 90 days, modified Rankin scale 0–1 occurred in 69.4% with endovascular therapy versus 50.0% with medical management (odds ratio 2.32; 95% CI 1.41–3.81; P<0.001), with symptomatic intracranial hemorrhage in 3 patients per group.