Outcomes for patients presenting with severe stroke because of large vessel occlusion have not improved much over recent years. Mechanical thrombectomy is one of the numerous advances in the field of endovascular technology. Endovascular techniques to diagnose and treat cerebral bleeding and for thrombolysis have been in use for several years, but the removal of clots to enable revascularisation of cerebral vessels is a relatively new technique. This change in treatment required a redesign of the treatment pathway. Mechanical thrombectomy is widely used in Europe and the USA, but is relatively new to the UK. Since January 2010, after clinical governance and trust board approval, the University Hospital of North Midlands (UHNM) has used endovascular treatment for patients with large vessel occlusions.