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Related Experiment Video

Updated: Apr 11, 2026

Quantification of Neurovascular Protection Following Repetitive Hypoxic Preconditioning and Transient Middle Cerebral Artery Occlusion in Mice

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Published on: May 4, 2015

Salvageable Time Window: Tissue Clock After Acute Ischemic Stroke Onset.

Feifeng Liu^1,2, Chushuang Chen³, Chen Chen^1,2

¹Department of Neurology (F.L., Chen Chen, G.L., L.L.), Shanghai East Hospital, School of Medicine, Tongji University, China.

|August 7, 2025

Summary

Endovascular therapy (EVT) for acute ischemic stroke is most beneficial within the salvageable time window. Initiating EVT beyond this window offers limited benefits and increases bleeding risks, highlighting the importance of time-sensitive treatment.

Keywords:

acute ischemic stroke intracranial hemorrhages perfusion imaging thrombectomy

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Area of Science:

Neurology
Interventional Radiology
Stroke Medicine

Background:

Salvageable ischemic tissue is the primary target for endovascular therapy (EVT) in acute ischemic stroke.
A novel concept of a 'salvageable time window' was introduced to quantify the dynamic process of tissue salvageability.
The hypothesis posited that EVT administered after this window would yield diminished patient benefits.

Purpose of the Study:

To evaluate the efficacy and safety of endovascular therapy (EVT) based on a defined salvageable time window in acute ischemic stroke patients.
To compare outcomes between patients receiving EVT within, outside, and not receiving EVT, using propensity score matching.

Main Methods:

A retrospective multicenter study (INSPIRE registry) included 1291 patients with large vessel occlusion stroke within 6 hours of onset.
Patients were grouped based on EVT timing relative to the calculated salvageable time window (within, outside, no EVT).
The primary outcome was good functional outcome (modified Rankin Scale 0-2 at 3 months); propensity score matching was used to control for confounding factors.

Main Results:

EVT within the salvageable time window significantly improved functional outcomes compared to no EVT (48% vs. 29%, OR 2.29) with no increased bleeding risk.
EVT initiated outside the salvageable time window did not improve functional outcomes (32% vs. 29%) and was associated with a higher risk of parenchymal hematoma (17% vs. 3%).

Conclusions:

Estimating the salvageable time window is crucial for optimizing EVT in acute ischemic stroke.
Timely EVT initiation within the salvageable window is associated with better functional outcomes and safety.
Delaying EVT beyond the salvageable time window may negate treatment benefits and increase complication risks.