Learning Objectives:

1. LVO thrombectomy trials were designed to confirm efficacy of the intervention in ideal patients.
2. The benefit of thrombectomy in LVO is so powerful that many "trial-ineligible" patients are likely to derive benefit from the intervention.
3. Future interventional trials ought to use a tiered approach to inclusion criteria or intervention type in order to maintain equipoise with randomization as a treatment benefit is observed in populations which are clearly expected to benefit.