This podcast explores recent studies that challenge the efficacy of thrombectomy as a treatment for medium vessel occlusions (MeVOs) and distal vessel occlusions (DVOs) in stroke patients. With emerging evidence suggesting minimal benefits compared to best medical treatment, the discussion highlights the need to reassess treatment strategies and patient selection for these types of strokes. The risks associated with thrombectomy, including higher rates of symptomatic intracranial haemorrhage, underscore the necessity for further research and innovation in the field.