In this podcast, we discuss the COMPASS: a trial of aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion, comparing patients with and without prior intravenous (IV) alteplase administration.

JNIS Editor-in-Chief, Felipe C. Albuquerque, interviews Maxim Mokin, from the Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, USA, about the post hoc analysis. which concludes that prior administration of IV alteplase may adversely affect the efficacy of aspiration, whilst it does not seem to influence the stent retriever first approach to MT in patients with anterior circulation ELVO.