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Predictors of clinically meaningful recanalization were assessed in 126 patients with acute anterior circulation stroke treated with IV thrombolysis. End points were CT angiographic recanalization and good clinical outcome at 90 days. Clinically meaningful recanalization occurred in 29% of patients, who had fewer neurologic deficits and higher ASPECTS at baseline. Admission NIHSS score and site of arterial occlusion were significant predictors of meaningful recanalization. Specifically, mild baseline deficits and distal vessel occlusions were significant predictors of clinically meaningful recanalization. A combination of these was better than either parameter alone.