1. Four recently completed trials demonstrate that early mechanical stent-thrombectomy after tPA in patients with large vessel occlusion and salvageable tissue on brain imaging results in improved reperfusion and functional outcomes.
2. The details of the patient selection paradigm remain a key discussion, but favorable penumbral imaging is a consistent feature of all trials.
3. Systems of acute care, including transfer protocols, will need to be re-organized to deliver this therapy effectively in the real world