ABSTRACT NUMBER: ESOC2026LB73 LB73 - ENDOVASCULAR TREATMENT FOR MILD ISCHEMIC STROKE WITH ACUTE ANTERIOR CIRCULATION LARGE VESSEL OCCLUSION:A MULTICENTER, PROSPECTIVE, RANDOMIZED, CLINICAL TRIAL (MILD-MT)

Abstract Background and aims Acute ischemic stroke (AIS) with National Institutes of Health Stroke Scale (NIHSS) score < 6 is termed as mild stroke. The benefit of endovascular therapy (EVT) for mild stroke patients caused by large vessel occlusion (LVO) is uncertain.This trial aims to explore the efficacy and safety of EVT in patients with mild ischemic stroke caused by acute anterior circulation LVO based on perfusion imaging screening. Methods MILD-MT trial is a multicenter, prospective, randomized, open-label, blinded endpoint (PROBE) trial designed to evaluate whether EVT combined with best medical management (EVT+BMM) is superior to BMM alone in mild stroke patients due to anterior circulation LVO patients are at high risk early neurological deterioration and could be benefit from screening with perfusion imaging. The primary efficacy outcome is the rate of excellent outcome at 90±7 (mRS score 0-1) days. Results Since its initiation in January 2024, the trial completed enrollment of all 300 patients by October, 2025 across 26 hospitals in China. All patients have completed the follow-up.The trial is scheduled to lock data by late March 2026. Study findings will be presented at this conference. Conclusions The MILD-MT trial is the first RCT to investigate the efficacy and safety of EVT in mild stroke patients caused by LVO screening with perfusion imaging.The results of this study will result in substantial evidence regarding the efficacy and safety of EVT for mild patients with AIS-LVO and large salvageable volume within 24 hours from symptom onset. Conflict of interest