Carotid T - or L-type occlusion ( terminal internal carotid artery [ ICA ] with M1 middle cerebral artery and/or A1 anterior cerebral artery involvement ) or tandem ( extracranial or intracranial ) ICA and M1 occlusion subgroup also showed a trend favoring endovascular treatment over IV tPA alone for primary outcome ( 26 % [ 12 of 46 ] vs 4 % [ one of 23 ] , P = .047 ) .