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Updated: Feb 3, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
MR Imaging Selection of Acute Stroke Patients with Emergent Large Vessel Occlusions for Thrombectomy
Thabele M Leslie-Mazwi1, Michael H Lev2, Pamela W Schaefer3
1Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, WAC-7-745, MGH, 15 Parkman Street, Boston, MA 02114-3117, USA; Neurocritical Care, Massachusetts General Hospital, Harvard Medical School, WAC-7-745, MGH, 15 Parkman Street, Boston, MA 02114-3117, USA; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, WAC-7-745, MGH, 15 Parkman Street, Boston, MA 02114-3117, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, WAC-7-745, MGH, 15 Parkman Street, Boston, MA 02114-3117, USA.
Abstract:
Acute stroke caused by large vessel occlusions (LVOs) are common. The time window to treat is up to 24 hours, and the most important factor is the size of the ischemic core. If the core is small (<70-100 mL), the penumbra must be large; penumbral imaging is unnecessary. MR imaging is precise in measuring the core, and superior to alternatives. The necessary sequences are obtainable rapidly, comparable to computed tomography scans. Available evidence suggests that most patients with LVOs are slow progressors defined as having a small core 6 hours or more after ictus onset.
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