RT Journal Article
SR Electronic
T1 Impact of Modified TICI 3 versus Modified TICI 2b Reperfusion Score to Predict Good Outcome following Endovascular Therapy
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 90
OP 96
DO 10.3174/ajnr.A4968
VO 38
IS 1
A1 C. Dargazanli
A1 A. Consoli
A1 M. Barral
A1 J. Labreuche
A1 H. Redjem
A1 G. Ciccio
A1 S. Smajda
A1 J.P. Desilles
A1 G. Taylor
A1 C. Preda
A1 O. Coskun
A1 G. Rodesch
A1 M. Piotin
A1 R. Blanc
A1 B. Lapergue
YR 2017
UL http://www.ajnr.org/content/38/1/90.abstract
AB BACKGROUND AND PURPOSE: The TICI score is widely used to evaluate cerebral perfusion before and after the endovascular treatment of stroke. Recent studies showing the effectiveness and safety of mechanical thrombectomy combine modified TICI 2b and modified TICI 3 to assess the technical success of endovascular treatment. The purpose of this study was to determine how much clinical outcomes differ between patients achieving modified TICI 2b and modified TICI 3 reperfusion.MATERIALS AND METHODS: We analyzed 222 consecutive patients with acute large intracranial artery occlusion of the anterior circulation having achieved modified TICI 2b or modified TICI 3 reperfusion after thrombectomy. The primary end point was the rate of favorable outcome defined as the achievement of a modified Rankin Scale score of 0–2 at 3 months.RESULTS: Patients with modified TICI 3 more often had favorable collateral circulation and atherosclerosis etiology, with a shorter time from onset to reperfusion than patients with modified TICI 2b (all P < .05). The number of total passes to achieve reperfusion was higher in the modified TICI 2b group (median, 2; interquartile range, 1–3, 1–9) versus (median, 1; interquartile range, 1–2, 1–8) in the modified TICI 3 group (P = .0002). Favorable outcome was reached more often for patients with modified TICI 3 than for those with modified TICI 2b (71.7% versus 50.5%, P = .001), with a similar difference when considering excellent outcome. In addition, patients with modified TICI 3 had a lower intracerebral hemorrhage rate (23.0% versus 45.0%, P < .001).CONCLUSIONS: Patients with modified TICI 3 reperfusion have better functional outcomes than those with modified TICI 2b. Given the improving reperfusion rates obtained with thrombectomy devices, future thrombectomy trials should consider modified TICI 2b and modified TICI 3 status separately.ADAPTA Direct Aspiration First-Pass TechniqueICHintracranial hemorrhageIQRinterquartile rangemTICImodified TICI