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For both intravenous thrombolysis and endovascular stroke treatment, the average efficacy of the intervention gradually decreases as the time from symptom onset increases. But for an individual patient, an irreversible core infarct can set in within minutes or ample collateral flow may be available to sustain ischemic tissue over hours. Imaging-based criteria to distinguish core infarct from salvageable penumbra could help to select individual patients for reperfusion therapy irrespective of time.
The NIH-sponsored CRISP (CT Perfusion to Predict Response to Recanalization in Ischemic Stroke Project) study tested this theory. Researchers enrolled 201 consecutive patients with anterior circulation stroke who were scheduled for endovascular the…