Endovascular Treatment Versus Medical Care for Stroke Caused by a Blocked Medium-Sized Brain Artery
Compares a clot-removal procedure with standard medicine in adults with ischemic stroke.
Plain-language title generated from the registry record
Registry title: Advancing Reperfusion Therapy for Ischemic Stroke: Perfusion-guided Endovascular Intervention for Medium Vessel Occlusion Therapy
Key facts
- Where
- Beijing, Changle, Longzhou, Luoyang, and Panlong, ChinaSee the 6 sites
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults who had a stroke from a blocked medium-sized brain artery within the last 24 hours. It tests a procedure guided by brain blood-flow scans against standard medical care.
- Age
- 18 years or older
- Sex
- All sexes can join.
- Disease stage
- Stroke caused by a blocked medium-sized artery in the brain, with symptoms starting within 24 hours (last seen normal). Stroke severity score (NIHSS) of 8 or more. Before the stroke, mRS score of 1 or less. Brain scan shows a target mismatch: core volume under 70 mL, mismatch rate over 1.2, mismatch volume over 10 mL.
- Earlier treatment
- The blocked vessel must not have reopened before randomisation. People who joined other interventional trials in the last 3 months cannot join.
- Biomarker or test result
- The blockage must be confirmed by CTA/MRA. A CT perfusion or MRI perfusion scan must show the target mismatch.
Main reasons for not taking part
- Bleeding in the brain on the scan
- Several blocked arteries
- Large dark area (over 1/3 of the MCA territory) on non-contrast CT
- Terminal illness, not expected to live more than 1 year
- Pregnant or nursing women, or unwilling to use effective contraception during the trial
Read by machine on 9 November 2026.
Where in China
- Beijing Daxing District People's HospitalBeijing, ChinaContact: Chunmiao DuanTaking people
- Beijing Tiantan HospitalBeijing, ChinaContact: Yunyun Xiong, professorTaking people
- Changle People's HospitalChangle, ChinaContact: Ruiguang LiuTaking people
- Xingtang County People's HospitalLongzhou, ChinaContact: Yanxin WangTaking people
- Luoyang Yiluo HospitalLuoyang, ChinaContact: Yajun YangTaking people
- People's Hospital of QueshanPanlong, ChinaContact: Jianxin XuTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- Beijing Tiantan Hospital
- Trial code
- NCT07323368
- Record updated
- 10 February 2026
- Original description
The investigators initiated a multicenter, prospective, randomized, open label, blinded-endpoint (PROBE) controlled trial to evaluate the efficacy and safety of perfusion-guided endovascular treatment (EVT) compared to standard medical care for patients with acute ischemic stroke due to medium vessel occlusion (MeVO) within 24 hours from symptom onset.Read full original descriptionShow less
Advancing Reperfusion Therapy for Ischemic Stroke (ARTS): Perfusion-guided Endovascular Intervention for Medium Vessel Occlusion Therapy (PIVOT)
The investigators initiated a multicenter, prospective, randomized, open label, blinded-endpoint (PROBE) controlled trial to evaluate the efficacy and safety of perfusion-guided endovascular treatment (EVT) compared to standard medical care for patients with acute ischemic stroke due to medium vessel occlusion (MeVO) within 24 hours from symptom onset.
Inclusion: Age≥18 years old; Acute ischemic stroke symptom onset within 24 hours; including wake-up stroke and unwitnessed stroke, onset time refers to "last-seen normal time"; Primary medium vessel occlusions confirmed by CTA/MRA, including non-dominant proximal M2 or mid-distal M2/M3 segments of the middle cerebral artery (MCA), A1/A2/A3 segments of the anterior cerebral artery (ACA), and P1/P2/P3 segments of the posterior cerebral artery (PCA) and responsible for the signs and symptoms of acute ischemic stroke; Pre-stroke modified Rankin scale (mRS) score ≤1; Baseline National Institutes of Health Stroke Scale (NIHSS) ≥8; Neuroimaging criteria: Target mismatch profile on CT perfusion or MRI+MR perfusion (ischemic core volume <70 mL, mismatch rate >1.2, mismatch volume >10 mL); Written informed consent from patients or their legally authorized representatives.
Exclusion: Evidence of vessel recanalization prior to randomisation; Participation in other interventional clinical trials within the previous 3 months; Any evidence of intracranial hemorrhage on qualifying imaging; Known history of arterial tortuosity, pre-existing stent, other arterial disease and/or known disease at the arterial access site that would prevent the device from reaching the target vessel and/or preclude safe recovery after EVT; Any terminal illness such that the patient would not be expected to survive more than 1 year; Known (serious) sensitivity to radiographic contrast agents, nickel, titanium metals or their alloys and unable to complete CTP/PWI; Radiological confirmed evidence of mass effect or intracranial tumour (except small meningioma); Clinical diagnosis of cerebral vasculitis; Severe comorbidities, which will likely prevent improvement or follow-up; Hypodensity in >1/3 MCA territory on non-contrast CT or significant hypodensity outside the current perfusion lesion suggesting distal clot migration (secondary MeVO); Multiple arterial occlusion; Pregnant women, nursing mothers, or reluctance to use effective contraceptive measures during the period of the trial; Unlikely to adhere to the trial protocol or follow-up.