Chalos V, et al. - In this observational study, researchers sought to determine the possible benefits of intravenous thrombolysis (IVT) with alteplase before endovascular treatment (EVT) in patients suffering acute ischemic stroke induced by a large vessel occlusion. For this purpose, they compared patients who received both IVT and EVT vs those treated with only EVT in routine clinical practice, focusing on clinical and procedural outcomes, safety, and workflow in the Multicenter Randomised Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands Registry. A total of 1,485 patients were included; 1,161 (78%) received IVT+EVT, and 324 (22%) received only EVT. They found that better clinical outcomes were achieved with IVT+EVT treatment compared to patients who received only EVT. Compared those treated with EVT alone, those treated with IVT+EVT had atrial fibrillation less often (16% vs 44%) and had better pre-stroke modified Rankin Scale scores (pre-stroke modified Rankin Scale 0: 73% vs 52%). Better functional and lower mortality was also linked to IVT+EVT.