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Redefining Ischemic Core, Penumbra, and Target Mismatch on Perfusion Imaging in Acute Anterior Distal Medium Vessel Occlusion

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Retrospective analysis clarifies ischemic core and penumbra metrics in medium vessel occlusions, suggesting improved EVT criteria.

rCBF <38% best correlates with infarct volumes in recanalized patients, outperforming rCBF <30%.
Tmax >8 s shows the strongest correlation with follow-up infarct volumes in unrecanalized patients.
Revised mismatch criteria improved outcome prediction for patients undergoing EVT, enhancing treatment selection.
Findings indicate that previous EVT trials may have suffered due to poor patient inclusion criteria.

Cai et al. (2025) studied this question.

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