Lower NWU on admission CT predicted meaningful benefit from EVT in large-core stroke.

A 15% NWU cutoff differentiated who gained from EVT vs who did not.

Study included 207 adults with ASPECTS 3–5 across 41 centers in Europe and Canada.

EVT plus BMT improved functional outcomes only in patients with NWU <15%.

EVT achieved complete MCA reperfusion in 64% of treated adults.

Intracerebral hemorrhage occurred in 46% of patients, with no between-group difference.

NWU is obtainable on standard noncontrast CT, offering a practical biomarker for EVT decision-making.