Medium- and Distal-Vessel Occlusion — The Limit of Thrombectomy?

Few procedures have gone through a decade of practice-changing clinical trials as impressive as thrombectomy for stroke. Beginning in 2015 with multiple trials showing a benefit with thrombectomy in early large-vessel occlusion, followed by the extended-window trials in 2018 and then the large core trials in 2023, it seemed that no corner of the cerebrovasculature would not have a substantial benefit from a proper clot removal — until now. The ESCAPE-MeVO (Endovascular Treatment to Improve Outcomes for Medium Vessel Occlusions) trial1 and DISTAL (Endovascular Therapy plus Best Medical Treatment [BMT] versus BMT Alone for Medium Vessel Occlusion Stroke — A . . .