Ischemic cerebral stroke is an increasingly treatable entity due to the recent developments in intravascular clot extraction, with recent research indicating that the efficacy of the chosen thrombectomy device may be affected by the composition of the occluding clot. This literature review summarizes the results from analytical clot imaging studies, and in vitro and in vivo thrombectomies, to assess whether the choice of thrombectomy device can be optimized to the composition of the occluding clot. The literature has shown that the composition of the clot impacts its mechanical properties and interactions with the device. The existing literature with respect to imaging and current results is discussed.