Although intravenous administration of tissue-type fibrinogen activator (tPA) for thrombolytic therapy has been widely used for more than 20 years, there is still much debate about the value of this drug in acute ischemic stroke due to large vessel occlusion (LVO). three randomized controlled trials published in NEJM in early 2013 found that endovascular therapy was not superior to clinical drug therapy in improving prognosis. This has increased clinicians’ doubts about the clinical effectiveness of endovascular therapy in acute ischemic stroke. A recent study published in J NeuroIntervent Surg found that, unlike previous trials, patients with large-vessel occlusions had good revascularization rates with clinical drugs, and that endovascular interventions in patients with acute ischemic stroke were significantly more effective than clinical drugs, and that this superiority was more pronounced in patients with diagnosed large-vessel occlusions. This superiority is even more pronounced in patients with confirmed large vessel occlusion. This paper echoes the recent Level I evidence from MR CLEAN, suggesting that endovascular interventions in acute ischemic stroke patients with confirmed macrovascular occlusions can achieve better clinical outcomes compared with clinical drug therapy. Professor Donglei Song is an internationally renowned neurointerventionist and the first doctor in China to be licensed to perform Onyx interventions. For many years, he has issued Onyx training certificates for dozens of doctors from Korea, Hong Kong, Macao and Taiwan, enjoying a good reputation among his colleagues at home and abroad. He has long been engaged in clinical work of brain surgery, specializing in microsurgery of cranial brain, and has performed more than 10,000 cases of cranial brain and spinal cord surgery. At present, he focuses on cerebrovascular imaging, intervention and microsurgery, and is one of the few neurosurgeons at home and abroad who are proficient in both intravascular embolization treatment and microsurgery, providing the best treatment for cerebrovascular patients. In recent years, he is responsible for more than 1700 cerebral angiograms and 800 interventional and microsurgical procedures for cerebrovascular diseases (including cerebral aneurysm, cerebrovascular malformation, dural arteriovenous fistula, traumatic cavernous sinus arteriovenous fistula, spinal cord vascular malformation, carotid artery stenosis, intracranial artery stenosis, surgical treatment of cerebral ischemic infarction, etc.) every year.