UNASSIGNED : Intravenous (i.v.) thrombolysis and mechanical thrombectomy are two essential pillars of acute stroke treatment in patients with vascular occlusion in the anterior circulation. The issue about using so-called bridging thrombolysis in acute stroke patients is increasingly under discussion. RESULTS : After application of i.v. thrombolysis treatment, stroke patients who were primarily transported to a neurovascular center and underwent timely endovascular treatment, showed a lower preinterventional recanalization rate, a lower 90-day mortality but no significant difference in the clinical outcome after 3 months compared with stroke patients with mechanical thrombectomy alone. Higher rates of intracranial hemorrhage could be detected in the bridging thrombolysis group of patients. CONCLUSIONS : The i.v. thrombolysis treatment is still an essential treatment concept in acute stroke management. Further studies should be carried out with respect to the application in mothership stroke patients undergoing early endovascular treatment.