Intravenous injection of recombinant tissue plasminogen activator (TPA) is the recommended first-line treatment for patients with acute ischemic stroke presenting early. When combined with mechanical thrombectomy, reperfusion rates of up to 90% can be achieved. However, complete reperfusion is only reached in a third of cases and outcomes at 3 months remain poor. Mikael Mazighi, MD, Université de Paris, Paris, France, discusses ongoing investigations into novel strategies to improve outcomes for patients with stroke undergoing endovascular therapy. New pharmacological therapies are being studied, including glenzocimab as an add-on therapy to alteplase. Investigators are also aiming to broaden the indications of thrombectomy, assessing the benefit-risk ratio in patients with distal vessel occlusions. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.