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. Author manuscript; available in PMC: 2022 Aug 1.
Published in final edited form as: Stroke. 2021 Jul 8;52(8):2723–2733. doi: 10.1161/STROKEAHA.121.035132

Table 1 –

Imaging selection criteria in trials extending the time window for reperfusion therapies

Parameter DAWN DEFUSE 3 EXTEND ECASS4 WAKE-UP
Ischemic core Diffusion MRI: ADC<620 Diffusion MRI: ADC<620 Diffusion MRI: ADC<620 Diffusion MRI: visual assessment Diffusion MRI: visual assessment
CT perfusion: relative CBF<30% CT perfusion: relative CBF<30% CT perfusion: relative CBF<30% N/A N/A
Critical hypoperfusion Tmax>6s Tmax>6s Tmax>6s Perfusion MRI: visual assessment N/A
Mismatch criteria Clinical-core mismatch (RAPID):
Age>80, NIHSS>10, core<20mL
Age<80, NIHSS10–19, core<30mL
Age<80, NIHSS≥20, core<50mL
Automated perfusion mismatch (RAPID): core<70mL
mismatch ratio≥1.8
mismatch volume≥15 mL
Automated perfusion mismatch (RAPID): core<70mL
mismatch ratio>1.2
mismatch volume>10 mL
Visual perfusion mismatch: core<70mL
mismatch ratio>1.2
mismatch volume>10 mL
Visual diffusion-FLAIR mismatch: Diffusion abnormal without corresponding significant FLAIR hyperintensity
Outcome: Benefit of EVT 6–24h Benefit of EVT 6–16h Benefit of IVT 4.5–9h and 9h after midpoint of sleep for wake-up stroke Neutral Benefit of IVT <4.5h after symptom discovery for wake-up/unknown onset

CBF – cerebral blood flow; Tmax – time to maximum; NIHSS – National Institutes of Health Stroke Scale; FLAIR – fluid-attenuated inversion recovery