Key Insights from Three Stroke 🧠 Trials: OPENS-2 and DISTAL & ESCAPE-MeVO trials

Three recent trials investigated the effectiveness of endovascular treatment (EVT) in ischemic stroke. The OPENS-2 trial (Lancet 2025) found that normobaric hyperoxia combined with EVT improved 90-day functional outcomes for large-vessel occlusion stroke without increasing adverse events. The DISTAL trial (NEJM 2025) reported no significant benefit of EVT over medical therapy for medium/distal vessel occlusions and noted a higher risk of hemorrhage. Similarly, the ESCAPE-MeVO trial (NEJM 2025) found no improvement with EVT in medium-vessel occlusion stroke, alongside increased mortality and intracranial hemorrhage. Collectively, these findings suggest that EVT's benefits depend on vessel size and may be enhanced with adjunctive treatments like hyperoxia in specific cases.