Intra-arterial therapy for acute stroke: trials and tribulations.

Intra-arterial therapy (IAT) for acute ischemic stroke has undergone great evolution during the past decade. While intra-venous therapy remains the standard of care for eligible patients, there are those patients in whom IV tPA is contraindicated, or those who fail to improve following IV tPA. In those cases, patients with accessible arterial occlusions may benefit from IAT, especially when recanalization can occur within six hours from symptom onset. Future advancements in device development and patient selection may further improve outcomes.