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While the efficacy and safety of mechanical thrombectomy (MT) for anterior large vessel occlusion (LVO) have been established, the effectiveness and safety for medium vessel occlusion (MeVO) are not clear.

Medium vessel occlusions (MeVOs, i.e., M2, M3, A2, A3, P2, and P3 segment occlusions) are ...

While the efficacy and safety of mechanical thrombectomy (MT) for anterior large vessel occlusion (LVO) have been established, the effectiveness and safety for medium vessel occlusion (MeVO) are not clear.

Medium vessel occlusions (MeVOs, i.e., M2, M3, A2, A3, P2, and P3 segment occlusions) are increasingly recognized as a target for endovascular treatment in acute ischemic stroke. However, it is essential to note that all MeVOs are heterogeneous.

Considering the rapid improvement in stroke treatment technology and the poor prognosis of MeVOs with medical management alone, endovascular therapy (EVT) for MeVOs could be the next step forward in acute ischemic stroke treatment.

The goal of this Research Topic is to cover all aspects of limitations of treatment of acute ischemic stroke with MeVO, including patient selection for MT, diagnostic imaging, and adjunctive treatment options such as intraarterial (IA) tissue-type plasminogen activator (t-PA).

MeVO is a highly heterogeneous disease, with variability in neurological severity, core volume, and penumbra volume. Therefore, computed tomography perfusion (CTP) or magnetic resonance perfusion (MRP) may help identify a group for which MT is effective. In addition, for peripheral lesions that are difficult to induce with MT devices, intravenous (IV) tenecteplase and IA tenecteplase may be one of the options in the future as an additional treatment option.

The aim of this Research Topic is to consider ways to improve patient selection and thrombolysis/mechanical thrombectomy rate, especially in situations not covered by guidelines or RCTs, and to improve treatment and prevention of adverse events with or without reperfusion treatment.

Thus, topic editors will welcome any types of manuscripts supported by the Journal – comprised of research article, brief research article, review, and mini-review – pertaining, but not limited to the following themes:
• MT for MeVO
• IV thrombolysis for MeVO
• Intraarterial thrombolysis for MeVO
• Imaging for MeVO
• Anatomical features in MeVO

Conflicts of interest: Dr. Yoshimoto receives lecture fees from Takeda Pharmaceutical and Boehringer Ingelheim. Additionally, Dr. Yamagami reports having received research grants from Bristol-Myers Squibb and lecture fees from Stryker, Terumo, Medtronic, Medico’s Hirata, Johnson & Johnson, Bayer, Daiichi-Sankyo, Bristol-Myers Squibb, Boehringer Ingelheim, and Otsuka Pharmaceutical

Keywords: medium vessel occlusion, MeVO, thrombectomy, thrombolysis, adjunctive therapy


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