In theory, performing EVT in MeVO is more challenging, as the relatively smaller vessel size and more distal location compared to large vessel occlusions (LVO) potentially carry an increased risk of procedural complications. However, numerous non-randomized studies and a sub-group analysis from the HERMES collaboration have provided promising evidence that suggests safety and benefit of EVT for M2 occlusions. Recently developed smaller stent-retrievers and refined thrombectomy techniques have rendered safe and efficacious distal EVT possible.
Three key concepts will be evaluated in this trial:
(i) EVT in patients with MeVOs with disabling deficit will result in a greater proportion of patients with excellent clinical outcome compared to best medical care.
(ii) EVT in MeVO patients can be safely done.
(iii) EVT in MeVO patients results in better self-reported health-status compared to best medical care.
University of Calgary (From Medtronic)