Endovascular Therapy Improves Outcomes from Ischemic Stroke By Parth Rali, MD and Igor Titoff, DO Endovascular therapy for ischemic stroke has long been an attractive treatment modality for ischemic strokes, but until recently large randomized trials have not confirmed a benefit [1,2,3]. Two of these—IMS III1 and SYNTHESIS2—failed to prove the benefit of endovascular therapy (with-or-without tissue plasminogen activator) over tPA alone, and the IMS III trial was stopped prematurely for futility [1]. Another recent trial, MR RESCUE3 (February 2013), also found no benefit of endovascular therapy over tPA. Thus tPA has remained the gold standard of intravascular therapy for acute ischemic stroke [4]. [For a "gold standard" therapy, tPA for treatment of ischemic stroke is