Ischemic Stroke Endovascular Thrombectomy Indication — free guideline decision tool
Judge mechanical-thrombectomy eligibility from circulation, large-vessel occlusion, time window and imaging (NIHSS/ASPECTS/mismatch). Instant, browser-side.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
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No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Occluded circulation | Anterior (ICA/MCA M1) |
|---|---|
| Imaging-confirmed intracranial large-vessel occlusion | Yes |
| Onset (or last-known-well) to expected puncture time | ≤ 6h |
| NIHSS score | 12 |
| ASPECTS score | 8 |
| Pre-stroke mRS | 0–1 |
| Perfusion/clinical-core mismatch (meets DAWN/DEFUSE-3) | Meets |
→Thrombectomy recommendationThrombectomy recommended (Class I, Level A)
- Window/circulation：≤ 6h · anterior
- Assessment：Onset ≤ 6h, anterior large-vessel occlusion, pre-stroke mRS 0–1, NIHSS ≥ 6, ASPECTS ≥ 6 — thrombectomy recommended; perfusion imaging not required.
- Bridging thrombolysis：Patients meeting IV alteplase/tenecteplase criteria should be thrombolysed first, but bridge to thrombectomy without waiting for its effect
| Occluded circulation | Posterior (basilar artery, etc.) |
|---|---|
| Imaging-confirmed intracranial large-vessel occlusion | No/unconfirmed |
| Onset (or last-known-well) to expected puncture time | > 24h |
| NIHSS score | 12 |
| ASPECTS score | 8 |
| Pre-stroke mRS | > 1 |
| Perfusion/clinical-core mismatch (meets DAWN/DEFUSE-3) | Does not meet/not assessed |
→Thrombectomy recommendationInsufficient evidence for thrombectomy
- Note：Mechanical thrombectomy mainly targets imaging-confirmed intracranial large-vessel occlusion; without a confirmed LVO, generally do not perform thrombectomy and manage as routine ischemic stroke (including IV thrombolysis assessment)
- Basis：Chinese Guideline for Endovascular Treatment of Acute Ischemic Stroke 2023
Common questions
What is Ischemic Stroke Endovascular Thrombectomy Indication?
Judge mechanical-thrombectomy eligibility from circulation, large-vessel occlusion, time window and imaging (NIHSS/ASPECTS/mismatch). Instant, browser-side.
How is Ischemic Stroke Endovascular Thrombectomy Indication calculated? What is the core formula?
Requires imaging-confirmed intracranial LVO. Anterior circulation: ≤ 6 h with mRS 0–1, NIHSS ≥ 6, ASPECTS ≥ 6 → recommended (no perfusion needed); 6–16 h needs DAWN/DEFUSE-3 mismatch; 16–24 h needs DAWN. Posterior (basilar) within 24 h may be considered after selection. > 24 h: insufficient evidence.
When is Ischemic Stroke Endovascular Thrombectomy Indication used?
Assess endovascular thrombectomy indication in acute ischemic stroke.
What are the key clinical points for Ischemic Stroke Endovascular Thrombectomy Indication?
Without a confirmed large-vessel occlusion on CTA/MRA, thrombectomy is not indicated — manage as routine stroke including thrombolysis assessment. ≤ 6 h anterior circulation may proceed without perfusion imaging; 6–24 h requires CTP or DWI/PWI selection per DAWN/DEFUSE-3. Patients meeting IV thrombolysis criteria should be thrombolysed first, but bridge to thrombectomy without waiting for the drug's effect. Decisions also depend on the individual and the centre's capability; reperfuse as early as possible.
What are the limits and cautions when using Ischemic Stroke Endovascular Thrombectomy Indication?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Ischemic Stroke Endovascular Thrombectomy Indication calculated in practice? Can you show a worked example?
Inputs: Occluded circulation Anterior (ICA/MCA M1), Imaging-confirmed intracranial large-vessel occlusion Yes, Onset (or last-known-well) to expected puncture time ≤ 6h, NIHSS score 12, ASPECTS score 8, Pre-stroke mRS 0–1, Perfusion/clinical-core mismatch (meets DAWN/DEFUSE-3) Meets → Result: Thrombectomy recommendation Thrombectomy recommended (Class I, Level A)（Window/circulation: ≤ 6h · anterior, Assessment: Onset ≤ 6h, anterior large-vessel occlusion, pre-stroke mRS 0–1, NIHSS ≥ 6, ASPECTS ≥ 6 — thrombectomy recommended; perfusion imaging not required., Bridging thrombolysis: Patients meeting IV alteplase/tenecteplase criteria should be thrombolysed first, but bridge to thrombectomy without waiting for its effect） Inputs: Occluded circulation Posterior (basilar artery, etc.), Imaging-confirmed intracranial large-vessel occlusion No/unconfirmed, Onset (or last-known-well) to expected puncture time > 24h, NIHSS score 12, ASPECTS score 8, Pre-stroke mRS > 1, Perfusion/clinical-core mismatch (meets DAWN/DEFUSE-3) Does not meet/not assessed → Result: Thrombectomy recommendation Insufficient evidence for thrombectomy（Note: Mechanical thrombectomy mainly targets imaging-confirmed intracranial large-vessel occlusion; without a confirmed LVO, generally do not perform thrombectomy and manage as routine ischemic stroke (including IV thrombolysis assessment), Basis: Chinese Guideline for Endovascular Treatment of Acute Ischemic Stroke 2023）
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Judge mechanical-thrombectomy eligibility from circulation, large-vessel occlusion, time window and imaging (NIHSS/ASPECTS/mismatch). Instant, browser-side.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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