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Medium Vessel Occlusion Stroke (MeVO)SAIL MEVONCT07843797

SAIL-MEVO: Endovascular Treatment Versus Best Medical Therapy for Distal Vessel Occlusions

A study testing best medical therapy and Endovascular Treatment in people with Medium Vessel Occlusion Stroke (MeVO) and Stroke Acute, run by Hospital Universitari Vall d'Hebron Research Institute at 1 site in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Patients with acute ischemic stroke caused by distal or medium vessel occlusions (MeVOs) may experience significant disability despite receiving the current standard medical treatment. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
best medical therapy and Endovascular Treatment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
420 participants
Where
1 siteSpain
Study dates
Nov 2026to Jul 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 to 80 years.
  • Pre-stroke modified Rankin Scale (mRS) score of 0-1.
  • Baseline NIH Stroke Scale (NIHSS) score between 9 and 17.
  • Symptom onset to randomization less than 12 hours.
  • Acute ischemic stroke due to an isolated medium/distal vessel occlusion involving a non-dominant M2-M3 middle cerebral artery, A2-A3 anterior cerebral artery, or P2-P3 posterior cerebral artery confirmed by CTA or MRA.
  • Alberta Stroke Program Early CT Score (ASPECTS) ≥6 on non-contrast CT AND AI-predicted infarct core volume <10 mL on non-contrast CT (when available) AND AI-defined Tmax >6s volumen >30cc on CTP (when available).
  • Written informed consent obtained from the participant or a legally authorized representative in accordance with local regulations.

Who cannot join

  • Proximal large vessel occlusion (internal carotid artery or M1 segment) or tandem cervical internal carotid artery stenosis >70%.
  • Intracranial hemorrhage at baseline imaging.
  • Pregnancy.
  • Life expectancy less than 3 months.
  • Severe allergy to iodinated contrast media.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Marc Ribo, MD, PhD contact

934 89 30 00

marcriboj@hotmail.com

Spain1 site, 1 recruiting
  • Hospital Universitari Vall d'Hebron

    Barcelona, Barcelona, 08035

    MARC RIBO, MD PhD, 0034934893000, marc.ribo@vhir.org

    Marta Rubiera, MD PhD, marta.rubiera@vhir.org

    Recruiting

Other trials in Spain

About this study

Official title: SAIL-MEVO: Endovascular Treatment Versus Best Medical Therapy for Distal Vessel Occlusions - Randomized Controlled Trial

Patients with acute ischemic stroke caused by distal or medium vessel occlusions (MeVOs) may experience significant disability despite receiving the current standard medical treatment. Although endovascular treatment (EVT) is an established therapy for large vessel occlusions, its benefit in MeVO stroke remains uncertain.

The SAIL-MEVO trial is a prospective, multicenter, randomized controlled trial designed to evaluate whether EVT combined with best medical therapy improves functional outcomes compared with best medical therapy alone in selected patients with acute ischemic stroke due to MeVO. Eligible participants will be randomized in a 1:1 ratio to receive either best medical therapy alone or best medical therapy plus EVT using a standardized stepwise approach consisting of aspiration thrombectomy (ADAPT) followed, when necessary, by the SAIL technique (stent retriever-assisted intra-arterial lysis).

The primary objective is to determine whether EVT increases the proportion of patients achieving functional independence (modified Rankin Scale score 0-2) at 90 days after stroke. Secondary objectives include assessment of neurological recovery, infarct volume, quality of life, patient-reported outcomes, safety, and procedural outcomes.

Read the detailed description

Acute ischemic stroke due to medium and distal vessel occlusions (MeVOs) represents a substantial proportion of ischemic strokes. While endovascular treatment (EVT) is the standard of care for proximal large vessel occlusions, recent randomized trials have not demonstrated a consistent clinical benefit of EVT in MeVO populations. These neutral findings may reflect the heterogeneity of MeVO stroke, variability in patient selection, and differences in vascular anatomy and procedural complexity.

The SAIL-MEVO trial is an investigator-initiated, prospective, multicenter, randomized, open-label, blinded-endpoint (PROBE) trial designed to evaluate whether optimized EVT improves functional outcomes compared with best medical therapy (BMT) alone in carefully selected patients with acute ischemic stroke due to MeVO.

Participants aged 18 to 80 years presenting within 12 hours from symptom onset with an isolated distal vessel occlusion (non-dominant M2-M3 middle cerebral artery, A2-A3 anterior cerebral artery, or P2-P3 posterior cerebral artery), baseline NIHSS score between 9 and 17, ASPECTS ≥6, and an AI-predicted infarct core volume <10 mL on non-contrast CT will be eligible for enrollment.

Participants will be randomized in a 1:1 ratio to:

Best medical therapy (BMT) according to current stroke guidelines, including intravenous thrombolysis when indicated; or Best medical therapy plus endovascular treatment (EVT).

The EVT strategy consists of a standardized stepwise approach. Primary aspiration thrombectomy (ADAPT) will be performed first using a small-caliber distal aspiration catheter. If aspiration is unsuccessful or vascular anatomy prevents adequate catheter access, treatment will proceed using the SAIL technique, consisting of low-profile stent retriever deployment with localized intra-arterial thrombolysis according to the study operations manual.

The primary efficacy endpoint is functional independence, defined as a modified Rankin Scale (mRS) score of 0-2 at 90 days after randomization.

Secondary efficacy endpoints include ordinal mRS shift, excellent functional outcome (mRS 0-1), early neurological improvement, infarct volume at 24-48 hours, discharge disposition, hospital length of stay, health-related quality of life (EQ-5D-5L), return to work or usual activities, and patient-reported outcome measures.

Safety endpoints include symptomatic intracranial hemorrhage, any intracranial hemorrhage, subarachnoid hemorrhage, embolization to new territory, vessel perforation or dissection, access-site complications, device- or procedure-related serious adverse events, all-cause mortality, and serious adverse events through 90 days.

Approximately 420 participants will be enrolled across up to 10 comprehensive stroke centers. Clinical outcomes will be assessed by investigators blinded to treatment allocation, and imaging endpoints will be adjudicated by an independent central imaging core laboratory. An independent Data and Safety Monitoring Board (DSMB) will oversee participant safety throughout the study.

Being tested
best medical therapy, Endovascular Treatment
Keywords
Distal Vessel Occlusion, Medium Vessel Occlusion, MeVO, Endovascular Treatment, Mechanical Thrombectomy, Aspiration Thrombectomy, ADAPT, SAIL, Intra-Arterial Thrombolysis, Randomized Controlled Trial, Acute Ischemic Stroke, Modified Rankin Scale, NIHSS, AI Imaging, Infarct Core, Neurointervention, Stroke, PROBE Trial
Medical subject headings
Stroke, Ischemic Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • best medical therapyProcedure or surgery

    Guideline-based medical management for acute ischemic stroke, including intravenous thrombolysis when clinically indicated according to local and international stroke guidelines.

  • Endovascular TreatmentProcedure or surgery

    Endovascular treatment using a standardized stepwise protocol. Primary aspiration thrombectomy (ADAPT) is performed first using a small-caliber distal aspiration catheter. When aspiration is unsuccessful or vascular anatomy is unfavorable, treatment proceeds with the SAIL technique, consisting of deployment of a low-profile stent retriever with localized intra-arterial thrombolysis according to the study operations manual.

Study groups in NCT07843797
Study groupRoleWhat they receive
Best Medical Therapy (BMT)Active comparatorParticipants receive guideline-based best medical therapy for acute ischemic stroke, including intravenous thrombolysis when indicated according to current clinical guidelines.
Receives: Procedure: best medical therapy
Endovascular Treatment Plus Best Medical Therapy (EVT + BMT)ExperimentalParticipants receive guideline-based best medical therapy plus endovascular treatment. The endovascular strategy consists of a standardized stepwise approach using aspiration thrombectomy (ADAPT) as the first-line technique, followed by the SAIL technique (low-profile stent retriever with localized intra-arterial thrombolysis) when aspiration is unsuccessful or vascular anatomy is unfavorable.
Receives: Procedure: best medical therapy; Procedure: Endovascular Treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Functional Independence at 90 Days

    Proportion of participants achieving functional independence, defined as a modified Rankin Scale (mRS, range 0 to 6, lower better) score of 0-2, assessed 90 (±14) days after randomization.

    Measured: Assessment at 90 (±14) days after randomization

Secondary outcomes (8)
  1. Ordinal Modified Rankin Scale (mRS) Score

    Distribution of modified Rankin Scale (mRS, range 0 to 6, lower better) scores

    Measured: Assessment at 90 (±14) days after randomization

  2. Excellent Functional Outcome (mRS 0-1)

    Proportion of participants achieving a modified Rankin Scale (mRS, range 0-6, lower better) score of 0-1.

    Measured: Assessment at 90 (±14) days after randomization

  3. Early Neurological Improvement

    Proportion of patients acheiving an early neurological improvemente defined as a reduction in National Institute of Health Stroke Scale (NIHSS, range 0-42, lower better) score of ≥8 points from baseline or an absolute NIHSS ≤2 at 24 hours.

    Measured: 24 hours after randomization

  4. Infarct Volume

    Infarct volume measured by the central imaging core laboratory.

    Measured: 24-48 hours after randomization

  5. Discharge Disposition

    Discharge to home versus rehabilitation or other healthcare facility.

    Measured: At hospital discharge (up to 15 days from randomization)

  6. Length of Hospital Stay

    Duration of hospitalization measured in days.

    Measured: At hospital discharge (up to 15 days from randomization)

  7. EQ-5D-5L Score

    Health-related quality of life assessed by the EQ-5D-5L ((EuroQol 5-Dimension, 5-Level), descriptive system and EQ VAS). Two components will be reported: the descriptive system and the EQ visual analogue scale (EQ VAS). The descriptive system comprises five dimensions - mobility, self-care, usual activities, pain/discomfort, and anxiety/depression - each evaluated from 1 to 5 (no sumatory). A lower level on a dimension indicates better health. EQ VAS (vertical visual analogue scale: ranging from 0 - 100. Higher scores indicate better health)

    Measured: Assessment at 90 (±14) days after randomization

  8. Return to Work or Usual Activities

    Proportion of participants returning to work or usual daily activities.

    Measured: Assesement at 90 days (+-14) after randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Sep 2026
  2. Study startNov 2026 (estimated)
  3. Primary completionJan 2029 (estimated)
  4. Study completionJul 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomized in a 1:1 ratio to receive either best medical therapy (BMT) alone or best medical therapy plus endovascular treatment (EVT). The EVT arm follows a standardized stepwise approach consisting of aspiration thrombectomy (ADAPT) followed by SAIL when aspiration is unsuccessful or vascular anatomy is unfavorable.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
420 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07843797
Sponsor's protocol ID
SAIL-MEVO-RCT-V1.0
Acronym
SAIL MEVO
Status last verified
Nov 2026
First submitted
16 Jul 2026
Last updated
4 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The patients/representants have signed an informed consent that specifies that no sharing of personal data will be performed.

Questions about this trial

What is this clinical trial studying?

A study testing best medical therapy and Endovascular Treatment in people with Medium Vessel Occlusion Stroke (MeVO) and Stroke Acute, run by Hospital Universitari Vall d'Hebron Research Institute at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 4 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Marc Ribo, MD, PhD (934 89 30 00, marcriboj@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Functional Independence at 90 Days (time frame: Assessment at 90 (±14) days after randomization). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2026.

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