{
  "abstract": "Background Acute ischaemic stroke (AIS) with a National Institutes of Health Stroke Scale (NIHSS) score <6 is termed as mild stroke. The benefit of endovascular therapy (EVT) for patients with mild stroke caused by large vessel occlusion (LVO) is uncertain.Aim and design MILD-MT trial is a multicentre, prospective, randomised, open-label, blinded endpoint (PROBE) trial designed to evaluate whether EVT combined with best medical management (EVT+BMM) is superior to BMM alone in patients with mild stroke due to anterior circulation LVO. Eligible patients have confirmed intracranial carotid artery (ICA), middle cerebral artery (MCA M1/M2) segment with or without ipsilateral extracranial ICA occlusion, symptom onset within 24 hours, small core infarct (≤50 mL), and substantial perfusion mismatch (≥50 mL), a profile indicating high risk for early neurological deterioration.Sample size Aim to randomise 300 patients 1:1 to receive EVT+BMM (intervention) or BMM alone (control).Study outcomes The primary efficacy outcome is the proportion of excellent functional outcomes (defined as modified Rankin Scale 0 or 1 score) at 90±7 days. The primary safety outcomes include symptomatic intracranial haemorrhage within 48 hours according to the Heidelberg criteria; END is defined as an increase in NIHSS score ≥4 or ≥2 in any individual item within 7 days after randomisation and all-cause mortality at 90±7 days.Discussion The MILD-MT trial could 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.Trial registration number ( NCT06179017).",
  "authors": [
    {
      "affiliations": [
        "Cerebrovascular and Neuro-Intervention Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Meihua Wu"
    },
    {
      "affiliations": [
        "Cerebrovascular and Neuro-Intervention Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Tingyu Yi"
    },
    {
      "affiliations": [
        "Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China"
      ],
      "name": "Pengfei Xing"
    },
    {
      "affiliations": [
        "Cerebrovascular and Neuro-Intervention Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Yan-min Wu"
    },
    {
      "affiliations": [
        "Cerebrovascular and Neuro-Intervention Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Ding-lai Lin"
    },
    {
      "affiliations": [
        "Cerebrovascular and Neuro-Intervention Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Xiaohui Lin"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Fujian Medical University Union Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Ming-Zhu Huang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China"
      ],
      "name": "Zeguang Ren"
    },
    {
      "affiliations": [
        "Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China"
      ],
      "name": "Jianmin Liu"
    },
    {
      "affiliations": [
        "Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China"
      ],
      "name": "Pengfei Yang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Jiujang Water of Life Hospital, Jiujiang, Jiangxi, China"
      ],
      "name": "Tuanyuan Zheng"
    },
    {
      "affiliations": [
        "Liaocheng People’s Hospital, Liaocheng City, Shandong, China"
      ],
      "name": "Meng Zhang"
    },
    {
      "affiliations": [
        "Linyi People’s Hospital, Linyi, Shandong, China"
      ],
      "name": "Hao Wang"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Fujian Medical University Union Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Wenhuo Chen"
    }
  ],
  "title": "Endovascular treatment for MILD ischaemic stroke with acute anterior circulation large vessel occlusion: a multicentre, prospective, randomised, clinical trial (MILD-MT) protocol",
  "uid": "55c7d05d-0e90-5a10-8ef9-a68a2d50dd56"
}