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We have read with great interest the recent publication by Midtlien et al in the Journal of NeuroInterventional Surgery,1 titled ’One in six patients exhibit changes in reperfusion on 10-minute repeat cerebral angiography during mechanical thrombectomy for stroke’. The study presents valuable insights into the incidence of target vessel re-occlusion (TVR) following endovascular thrombectomy (EVT) and its impact on patient outcomes. We commend the authors for their pioneering work in this area and wish to contribute to the discussion with some considerations and queries that we believe merit further exploration.