Seners P, et al. - This study draws on data from a large multicenter French registry to identify strong predictors of lack of post-intravenous thrombolysis [IVT] early recanalization (ER)—a surrogate marker of poor outcome. Using the susceptibility vessel sign on T2* imaging, thrombus length was measured. The median length of the susceptibility vessel sign was 9.2 mm on pre-IVT MRI. The C statistic of susceptibility vessel sign length for no-ER prediction was 0.82 and the optimal cutoff (Youden) was 9 mm. In this cohort of patients treated with IVT minor stroke with large vessel occlusion considered for thrombectomy, ER was frequent, and the length of the thrombus was a powerful independent predictor of no-ER. In this population, these findings can help design randomized trials aiming to test bridging therapy vs IVT alone.