I Evolution of Endovascular Management 1 Intra-arterial Tissue Plasminogen Activator: The First Steps 2 Transcatheter MERCI Clot Retrieval: The Early Generation 3 Penumbra Clot Aspiration Technique: The Dark Days 4 Trevo Stent-Retriever Thrombectomy: Light on the Horizon 5 Solitaire Stent-Retriever Thrombectomy: Building the Evidence II Case Selection 6 Timing in Stroke and the Tissue Clock 7 Role of Leptomeningeal Collaterals 8 Importance of Clot Burden and Clot Location 9 ASPECTS: When Not to Treat 10 Microbleeds Are Not a Contraindication to Thrombolysis in Acute Stroke 11 Stroke Etiologies: Hemodynamic, Embolic, and Perforator Stroke 12 Endovascular Therapy in a Patient with a Proximal MCA Occlusion and No Neurological Deficits 13 MRI in Stroke (Core Size, Mismatch, and New Advances) III Fundaments and Standard Approaches 14 The Classical Setup: Carotid-T with Balloon 15 M1 Anatomy and Role of Perforators in Outcome 16 Basilar Artery Occlusion 17 ADAPT Technique for Acute Ischemic Stroke Thrombectomy 18 General Anesthesia in Thrombectomy 19 Conscious Sedation in Thrombectomy 20 Endovascular Therapy for Patients with an Isolated M2 Occlusion IV Advanced Techniques 21 Percutaneous Radial Arterial Access for Thrombectomy 22 Percutaneous Transcarotid Endovascular Thrombectomy for Acute Ischemic Stroke 23 Distal Access Catheter Technique without Balloon Assistance V Complex Cases 24 Tandem Lesions 25 Pseudo-occlusion 26 Underlying Intracranial Stenosis 27 Intracranial Dissection 28 Hyperacute Extracranial Angioplasty and Stenting: When and How 29 Failed Mechanical Thrombectomy: What to Do Next 30 Rescue Permanent Stenting 31 Acute Dissection with Hemodynamic Infarctions 32 The SAVE Technique 33 Aspiration-Retriever Technique for Stroke (ARTS) VI Complications 34 Clot Migration with Emboli to Distal Territories 35 Endothelial Damage 36 Management of Vessel Perforation during Stroke Intervention 37 Arterial Access Complications 38 Intraprocedural Vasospasm during Thrombectomy 39 Hemorrhagic Transformation after Endovascular Stroke Therapy 40 Endovascular Treatment of Cerebral Venous Thrombosis 41 Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke VII Stroke Mimics and Rare Causes 42 Hemiplegic Migraine 43 Intra-arterial Contrast Injection during Computed Tomography Angiography 44 Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS) 45 Reversible Cerebral Vasoconstriction Syndrome 46 Acute Ischemic Stroke Secondary to Cardiac Myxoma Embolus 47 Seizure 48 Cerebral Amyloid Angiopathy 49 Contrast Staining Masquerading as Hemorrhage 50 HaNDL 51 Appendix: Essential Terms, Trials, and Tools