Original research manuscripts that were identified during the literature search
| First Author Year | Study type | N with MeVO EVT | NIHSS (median/mean) | ASPECTS (median/ mean) | Imaging modality used | Treatment criteria | MeVO type | Technique used | Anesthesia | Angiographic outcome | Clinical outcome | sICH |
| Romano et al 202027 | MC | 44 | 10 | 9 | NCCT+CTA (±DWI if onset unknown) | NIHSS≥6 Pre-stroke mRS 0–2 ASPECTS≥6 Absence of large infarction DWI-clinical mismatch Contraindication to IV tPA | M2, M2/M3 | DA | GA, CS | TICI 2b/3: 91% | mRS 0–2: 71% | 0% |
| Haussen et al 2020a34 | SC | 137 | 18 | 8/9 | NCCT+CTA+CTP | – | M2, M3 Any ACA Any PCA | DA, SR | – | TICI 2b/3: 84% (SR) vs 69% (DA) TICI 3: 58% (SR) vs 46% (DA) | mRS 0–2: 45% (SR) vs 46% (DA) | – |
| Atchaneeyasakul et al 202046 | MC | 197 | 15/17 | 9 | NCCT+CTA | Isolated MeVO (absence of concurrent LVO) | M2 | DA, SR | – | TICI 2b/3: 90% (SR) vs 77% (DA) | mRS 0–2: 52% (SR) vs 37% (DA) | 3% (SR) vs 5% (DA) |
| Jiang et al 201925 | SC | 37 | 15 | 10 | NCCT+CTA+CTP | Symptom onset ≤24 hour NIHSS ≥6 Pre-stroke mRS 0–1 ASPECTS ≥6 Absence of large infarction CTP mismatch ratio>1.8 | M2 | SR | CS | TICI 2b/3: 95% TICI 3: 76% | mRS. 0–2: 49% | 11% |
| Compagne et al 201923 | MC | 244 | 14 | 9 | NCCT+CTA | Symptom onset ≤6.5 hour | M2 | DA, SR, IA tPA | – | TICI 2b/3: 57% | mRS 0–2: 46% mRS 0–1: 26% mRS 0: 7% | 7% |
| Gory et al 201847 | RCT | 79 | 13.4 | 8 | – | – | M2 | DA, SR | CS, GA | TICI 2b/3: 84% (SR) vs 90% (DA) TICI 2 /3: 55% (SR) vs 54% (DA) TICI 3: 42% (SR) vs 35% (DA) | mRS 0–2: 50% (SR) vs 54% (DA) | 3% (SR) vs 6% (DA) |
| Qureshi et al 201748 | RCT | 34 | 16 | – | NCCT+CTA | Age 18–82y tPA eligibility Symptom onset ≤3 hour Absence of large infarction | M2 | SR, IA tPA | – | TICI 2b/3: 52.6% | mRS 0–2: 53% mRS 0–1: 38% | 6% |
| Vargas et al 201737 | SC | 35 | 14.1 | – | NCCT+CTA+CTP | Contraindication to IV tPA | M2, A3, combinations | DA | – | TICI 2b/3: 97% TICI 2c/3: 83% TICI 3: 43% | mRS 0–2: 59% | 3% |
| Sarraj et al 201649 | MC | 288 | 16 | 9 | NCCT+CTA | Symptom onset ≤8 hour | M2 | DA, SR±IA tPA | – | TICI 2b/3: 78% | mRS 0–2: 63% mRS 0–1: 36% mRS 0: 14% | 6% |
| Navia et al 201629 | SC | 6 | 12,5 | – | NCCT+CTA+CTP | NIHSS≥5 ASPECTS≥8 | M2, M3, P2, A2 | DA | CS and GA | TICI 2b/3: 100% TICI 3: 83% | mRS 02: 100% mRS 0–1: 60% mRS 0: 20% | 0% |
| Menon et al 201924 | RCT | 67 | 14 | 9 | NCCT+CTA (±CTP/MRI) | – | M2 | SR | – | TICI 2b/3: 59% | mRS 0–2: 58% mRS 0–1: 37% mRS 0: 19% | 0% |
| Coutinho et al 201650 | MC | 50 | 13 | 9 | NCCT+CTA (±CTP/MRI) | – | M2 | SR | CS, GA | TICI 2b/3: 85% | mRS 0–2: 60% mRS 0–1: 50% | 2% |
| Grossberg et al 201845 | SC | 69 | 18.1 | 8 | NCCT+CTA+CTP | Persisting disabling deficits despite IV tPA with occlusion location accounting for the symptoms | M3 Any ACA Any PCA | DA, SR | – | TICI 2b/3: 83% TICI 3: 45% | mRS 0–2: 30% mRS 0–1: 13% | – |
| Nakano et al 202051 | MC | 51 | 17 | 8 | – | – | M2 | DA, SR | – | TICI 2b/3: 84% | mRS 0–2: 49% | 3% |
| Altenbernd et al 201828 | SC | 58 | 15 | 9 | NCCT+CTA+CTP | Age ≥18 NIHSS ≥6 ASPECTS ≥8 | M2, M3 | DA | GA | TICI 2b/3: 100% TICI 3: 83% | mRS 0–2: 95% mRS 0–1: 86% mRS 0: 35% | 3% |
| Crockett et al 201936 | SC | 14 | 8 | 9 | – | – | A2, A3, P2, M3, SCA | DA | – | TICI 2b/3: 100% TICI 2c/3: 100% TICI 3: 91% | mRS 0–2: 63% mRS 0–1: 50% mRS 0: 43% | 0% |
| Bhogal et al 201752 | SC | 106 | 12 | 9 | NCCT+CTA or MRI | – | M2 | SR | – | TICI 2b/3: 91% TICI 3: 69% | mRS 0–2: 55% mRS 0–1: 45% mRS 0: 24% | 5% |
| de Castro Afonso et al 201926 | SC | 30 | 16 | 9 | NCCT+CTA | Symptom onset≤6 hour or CTP mismatch if symptom onset 6–24 hour NIHSS≥6 ASPECTS ≥6 | M2 | DA, SR, combination | CS, GA | TICI 2b/3: 90% TICI 2c/3: 60% TICI 3: 53% | mRS 0–2: 50% mRS 0–1: 23% mRS 0: 17% | 7% |
| Grieb et al 201930 | SC | 52 | 12 | – | NCCT+CTA | NIHSS ≥6 or aphasia Absence of large infarction | M2 | DA | GA | TICI 2b/3: 91% TICI 3: 65% | mRS 0–2: 56% | 0% |
| Pérez-García et al 202053 | SC | 102 | 16 | 9 | – | – | M2, M3, Any ACA Any PCA | SR, combination | CS, GA | TICI 2b/3: 50% (SR) vs 64% (combination) TICI 2c/3: 34% (SR) vs 57% (combination) | mRS 0–2: 53 (SR) vs 51% (combined) | 13% (SR) vs 2% (combination) |
| Haussen et al 2020b34 | SC | 22 | 17 | 8 | – | – | M2 | Combination | – | TICI 2b/3: 84% TICI 3: 64% | mRS 0–2: 40% | – |
| Pfaff et al 201654 | SC | 30 | 18 | 9 | DWI+MRA+ PWI or NCCT+CTA+CTP | Symptom onset ≤8 hour NIHSS ≥8 ASPECTS ≥6 | A2, A3, A4 | SR | CS, GA | TICI 2b/3: 73% | mRS 0–2: 37% | 0% |
| Styczen et al 202055 | MC | 15 | 13 | 10 (pcASPECTS) | – | – | SCA, AICA, PICA | SR, DA, combination, IA tPA | TICI 2b/3: 88% TICI 3: 31% | mRS 0–2: 50% mRS 0–1: 29% mRS 0: 7% | – |
Note: MC = multi center, SC = single center, EEVT = endovascular treatment, MeVO = medium vessel occlusion stroke, NIHSS = National Institutes of Health Stroke Scale, (pc)ASPECTS = (posterior circulation) Alberta Stroke Program Early CT Score, CTA = CT angiography, NCCT = non contrast head CT, DWI = diffusion weighted imaging, CTP = CT perfusion, DA = direct aspiration, SR = stent retriever, IA tPA = intra-arterial alteplase, CS = conscious sedation, GA = general anesthesia, SCA = superior cerebellar artery, AICA = anterior inferior cerebellar artery, PICA = posterior infereior cerebellar artery, TICI = Thrombolysis in Cerebral Infarction Score, mRS = modified Rankin Score, sICH = symptomatic intracranial hemorrhage