Large vessel occlusion (LVO), invariably being one of the primary causes of acute ischemic stroke, is associated with poor prognosis if left untreated.¹ Endovascular therapy (EVT) is the conventional treatment for LVO, in case the Alberta stroke program early computed tomography score (ASPECTS) is ≥6.¹ However, if the ischemic core infarction is large with an ASPECTS ≤5, the effectiveness of EVT as an LVO treatment is an unconfirmed observation that requires further conclusive investigations.¹ 

It has been established that speed is crucial for the management of acute ischemic stroke (AIS).1 Although traditional guidelines mainly provide treatment advice based on the standard time window, “tissue clock” illustrated by advance imaging has been shown to extend the treatment window for reperfusion therapies.^2-4