In imaging for acute stroke, what finding supports thrombectomy eligibility in terms of penumbra?

In imaging for acute stroke, what finding supports thrombectomy eligibility in terms of penumbra?

• A. No mismatch
• B. Normal perfusion with large vessel occlusion
• C. A favorable mismatch indicating penumbra
• D. Complete infarct core

Answer: (C)

The key idea is that thrombectomy is most beneficial when imaging shows tissue at risk but not yet dead—the penumbra. A favorable mismatch means the perfusion imaging reveals a larger area of hypoperfusion than the infarct core seen on diffusion or other core imaging, indicating there is salvageable tissue. This penumbra is what thrombectomy can save if reperfusion is achieved. If there were no mismatch, there wouldn’t be much salvageable tissue to save; a complete infarct core means essentially all tissue is already irreversibly damaged, and normal perfusion with an occlusion doesn’t fit the typical pattern of stroke requiring intervention. Thus, a favorable mismatch indicating penumbra best supports thrombectomy eligibility.

The key idea is that thrombectomy is most beneficial when imaging shows tissue at risk but not yet dead—the penumbra. A favorable mismatch means the perfusion imaging reveals a larger area of hypoperfusion than the infarct core seen on diffusion or other core imaging, indicating there is salvageable tissue. This penumbra is what thrombectomy can save if reperfusion is achieved. If there were no mismatch, there wouldn’t be much salvageable tissue to save; a complete infarct core means essentially all tissue is already irreversibly damaged, and normal perfusion with an occlusion doesn’t fit the typical pattern of stroke requiring intervention. Thus, a favorable mismatch indicating penumbra best supports thrombectomy eligibility.