Zi W, Qiu Z, Li F, et al. - Among patients with large vessel occlusion stroke, researchers ascertained if endovascular thrombectomy alone is not inferior to intravenous alteplase followed by endovascular thrombectomy for achieving functional independence at 90 days. In this randomized clinical trial, 116 patients were randomized to the endovascular thrombectomy alone group and 118 patients to combined intravenous thrombolysis and endovascular thrombectomy group. All 234 randomized patients (mean age, 68 years; 102 women [43.6%]) completed the trial. Endovascular therapy alone relative to intravenous alteplase plus endovascular therapy met the recommended statistical criterion for noninferiority for the outcome of 90-day functional independence in patients with ischemic stroke due to proximal anterior circulation occlusion within 4.5 hours of onset. Such results should be viewed in relation to the clinical acceptability of the selected noninferiority threshold.