Fig. 2

Step-by step illustration of the rendezvous approach. Illustration of the surgical and endovascular hybrid thrombectomy in patient 1. The blue timeline represents procedures performed by the neuroradiological team (NR), while the red one represents those performed by the vascular surgery team (VS). T0–T1: Initially, endovascular access was achieved by puncture of the femoral artery by NR. In the angiography, the internal carotid artery (ICA) did not show contrast enhancement (left) and several attempts to pass-through failed (right) prompting the involvement of the VS team after 0:39 h. T1–T2: The delay until takeover by VS lasted 0:23 h. T2–T3: Within 1:02 h, VS established the surgical access, performed a carotid endarterectomy of the ICA (left), and implanted a carotid sheath (right). T3–T4: NR took over again (left). Middle cerebral artery occlusion at the M1-level was still present (middle) and was recanalized by endovascular thrombectomy via the surgically implanted sheath (right; duration 0:21 h). T4–T5: After thrombectomy, the carotid sheath was removed and the wound was closed by VS (1:22 h). T0–T5: The entire procedure, from initial groin puncture to wound closure, lasted 3:46 h