🧠 Ischemic Stroke Endovascular Thrombectomy Indication
Judge mechanical-thrombectomy eligibility from circulation, large-vessel occlusion, time window and imaging (NIHSS/ASPECTS/mismatch). Instant, browser-side.
Ischemic Stroke Endovascular Thrombectomy Indication
Occluded circulation
Imaging-confirmed intracranial large-vessel occlusion
Onset (or last-known-well) to expected puncture time
NIHSS score
ASPECTS score
Pre-stroke mRS
Perfusion/clinical-core mismatch (meets DAWN/DEFUSE-3)
When to use
Assess endovascular thrombectomy indication in acute ischemic stroke.
How it works
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.
Key points
- 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.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.