Over the past years, improvements in clinical results after endovascular treatment for acute ischemic stroke have been noted in routine clinical practice, which are possibly consequent to improved workflow times and higher successful reperfusion rates.

• This study included patients with proximal occlusions of the anterior circulation from the second and first cohorts of the MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry (March 2014 to June 2016; June 2016 to November 2017, respectively) (second cohort n=1,692, first cohort n=1,488).

• In the second cohort, time from stroke onset to groin puncture and reperfusion were shorter (median 185 vs 210 minutes; and 236 vs 270 minutes, respectively).

• The second cohort more often had successful reperfusion than the first cohort (72% vs 66%).

• Significant improvement occurred in functional outcome (adjusted common odds ratio 1.23).

• Attenuation in this impact was brought about by adjustment for time from onset to reperfusion (adjusted common odds ratio, 1.12) and successful reperfusion (adjusted common odds ratio, 1.13).

• Results were consistent in the analysis per chronological quartile.