If you're shooting down on a close shot from a treestand and have to place the shot high in the chest to get both lungs, then you'd better get a passthru if you want a good blood trail.
That is so true. And if you are in this situation, it is very important to get a head that penetrates well. Which will probably not be the biggest diameter head.
I don't know about others, but I have also found that if you get an exit too low, that fat deposits can also clog up a hole.