Effectiveness and safety of endovascular therapy compared to intravenous thrombolysis in acute ischaemic stroke due to medium-vessel occlusions: a real-world multicentre study from the Italian SITS re
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- EVT (with or without IVT) did not improve 90-day functional independence compared to IVT alone for medium-vessel occlusion (MeVO) stroke (60.6% vs 60.9%).
- The EVT group had a significantly higher rate of overall intracranial hemorrhage (18.4% vs 11.2%), though symptomatic hemorrhage rates were similar.
- In-hospital mortality was lower in the EVT group (5.4% vs 8.7%) but the difference was not statistically significant.
- Subgroup analyses by stroke severity and treatment time showed no consistent benefit from EVT across groups.
- The results align with recent randomized trials (ESCAPE-MeVO, DISTAL) and suggest a cautious approach to EVT for MeVO stroke.