Acute ischemic stroke is one of the leading causes of morbidity and mortality in America and the leading cause of adult long-term disability. Strokes due to emergent large vessel occlusion (ELVO) often lead to significant disability; however, they also can be amenable to treatment with the potential for good functional outcome. Over a short period, the standard of treatment has evolved considerably, from supportive care to systemic therapy and now to targeted therapy. The role for mechanical thrombectomy had been debated for years, but in light of five back-to-back publications demonstrating its superiority, it is now considered standard of care in those patients who meet criteria. This article aims to introduce the reader to the progression of events leading to the current practice of endovascular embolectomy in ELVO.
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