Suzuki K, Matsumaru Y, Takeuchi M, et al. - In this randomized clinical trial involving 204 patients (median age, 74 years; 62.7% men; median National Institutes of Health Stroke Scale score, 18), experts explored if mechanical thrombectomy alone is not inferior to combined intravenous thrombolysis plus mechanical thrombectomy for favorable outcome following a stroke. Participants in the study were randomized to mechanical thrombectomy alone (n = 101) or intravenous thrombolysis (alteplase at a 0.6-mg/kg dose) combined with mechanical thrombectomy (n = 103). Mechanical thrombectomy alone, compared with combined intravenous thrombolysis plus mechanical thrombectomy, failed to show noninferiority with respect to a favorable functional outcome among patients with acute large vessel occlusion stroke. The wide confidence intervals around the effect estimate, however, also did not allow for an inferiority inference. A favorable functional outcome was seen in 59.4% of those randomized to mechanical thrombectomy alone and in 57.3% of those randomized to combined intravenous thrombolysis plus mechanical thrombectomy