Within what time window can mechanical thrombectomy be considered in select patients with favorable perfusion imaging or meeting DAWN/DEFUSE-3 criteria?

Within what time window can mechanical thrombectomy be considered in select patients with favorable perfusion imaging or meeting DAWN/DEFUSE-3 criteria?

• A. 0–6 hours
• B. 6–12 hours
• C. 12–24 hours
• D. 6–24 hours

Answer: (D)

The key idea is tissue-based timing. Mechanical thrombectomy isn’t limited to the first 6 hours for every patient; if imaging shows a small infarct core with a substantial amount of at-risk but salvageable tissue (a favorable perfusion mismatch) or if a patient meets DAWN/DEFUSE-3 criteria, reperfusion can be beneficial for longer—notably up to 24 hours after onset. Trials in this extended window demonstrated that selected patients still have better outcomes with thrombectomy, so the window extends from 6 to 24 hours in those cases.

The key idea is tissue-based timing. Mechanical thrombectomy isn’t limited to the first 6 hours for every patient; if imaging shows a small infarct core with a substantial amount of at-risk but salvageable tissue (a favorable perfusion mismatch) or if a patient meets DAWN/DEFUSE-3 criteria, reperfusion can be beneficial for longer—notably up to 24 hours after onset. Trials in this extended window demonstrated that selected patients still have better outcomes with thrombectomy, so the window extends from 6 to 24 hours in those cases.