Zhu Ma Dian Shi

Researchers are evaluating the effectiveness and safety of perfusion-guided endovascular treatment (EVT) compared to standard medical care in adults who have had an acute ischemic stroke caused by medium vessel occlusions in the brain. This study focuses on patients with specific artery blockages confirmed by imaging and aims to determine if EVT can improve functional outcomes within 24 hours of stroke symptom onset. The trial uses advanced imaging techniques to select patients who have a target mismatch profile indicating potentially salvageable brain tissue. Participants will be randomly assigned to receive either EVT combined with the best medical treatment or the best medical treatment alone. EVT may include procedures such as thrombectomy with stent retrievers, thromboaspiration, intraarterial thrombolysis, balloon angioplasty, stenting, or a combination of these methods, performed at the interventional team's discretion. Best medical treatment will follow routine clinical practice and current international guidelines and will not be delayed by study participation. During the study, participants will be monitored to assess their recovery, with the primary outcome measured by the proportion of patients achieving a modified Rankin Scale score of 0 or 1 at 90 days, indicating little to no disability. Evaluations include neuroimaging, neurological assessments, and safety monitoring throughout the 90-day follow-up period. The trial includes a screening process based on imaging and clinical criteria to ensure appropriate patient selection and adherence to the study protocol.