[Evaluation Method for Ascertaining Mechanical Thrombectomy]

Indications for mechanical thrombectomy have been expanding annually. However, imaging assessment for ischemic stroke has remained constant, and it cannot deal with the recently expanded indications for thrombectomy. The evaluation of salvageable tissue is necessary to predict outcomes after thrombectomy. In a recent article, six levels of ischemic stress were reported to express the tissue state in detail. The depth of ischemic stress in large ischemic cores can be described using the apparent diffusion coefficient (ADC). Using the ADC value, a detailed evaluation can be performed to ascertain mechanical thrombectomy in large ischemic cores. In contrast, in small ischemic core-like medium-vessel occlusions, perfusion imaging is important in determining thrombectomy. Arterial spin labeling is substituted for perfusion imaging. To deal with the expanded indications for thrombectomy, we must understand the role of each modality in detail. This article reports the evaluation of salvageable tissue under ischemic stress to address the expanded indications for thrombectomy.