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
Where in China
- Beijing Daxing District People's HospitalBeijing, ChinaTaking people
- Beijing Tiantan HospitalBeijing, ChinaTaking people
- Changle People's HospitalChangle, ChinaTaking people
- Xingtang County People's HospitalLongzhou, ChinaTaking people
- Luoyang Yiluo HospitalLuoyang, ChinaTaking people
- People's Hospital of QueshanPanlong, ChinaTaking 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?
Trial 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.