Endovascular therapy plus standard care vs standard care alone for distal and medium vessel strokes

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

SAIL-MEVO is a multicenter randomized trial comparing endovascular treatment plus best medical therapy to best medical therapy alone for acute ischemic stroke caused by distal or medium vessel occlusions. Eligible participants are adults aged 18-80 with specific imaging and clinical criteria, enrolled within 12 hours of symptom onset. The EVT approach uses a stepwise strategy starting with aspiration thrombectomy and, if needed, the SAIL technique with stent retrievers and intra-arterial lysis. The trial uses a PROBE design to assess functional outcomes and safety, aiming to clarify the potential benefit of EVT in MeVO strokes where prior trials have shown neutral results. Primary results focus on whether EVT increases the proportion of patients achieving functional independence at follow-up.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 18 to 80 years.
* Pre-stroke modified Rankin Scale (mRS) score of 0-1.
* Baseline NIH Stroke Scale (NIHSS) score between 9 and 17.
* Symptom onset to randomization less than 12 hours.
* Acute ischemic stroke due to an isolated medium/distal vessel occlusion involving a non-dominant M2-M3 middle cerebral artery, A2-A3 anterior cerebral artery, or P2-P3 posterior cerebral artery confirmed by CTA or MRA.
* Alberta Stroke Program Early CT Score (ASPECTS) ≥6 on non-contrast CT AND AI-predicted infarct core volume \<10 mL on non-contrast CT (when available) AND AI-defined Tmax \>6s volumen \>30cc on CTP (when available).
* Written informed consent obtained from the participant or a legally authorized representative in accordance with local regulations.

Exclusion Criteria:

* Proximal large vessel occlusion (internal carotid artery or M1 segment) or tandem cervical internal carotid artery stenosis \>70%.
* Intracranial hemorrhage at baseline imaging.
* Pregnancy.
* Life expectancy less than 3 months.
* Severe allergy to iodinated contrast media.

Where it's running

• Hospital Universitari Vall d'Hebron
  Barcelona, Barcelona, Spain Recruiting

Study contacts

• Study coordinator: Marc Ribo, MD, PhD
• Email: marcriboj@hotmail.com
• Phone: 934 89 30 00

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.