1.Thrombectomy in Stroke Patients With Low Alberta Stroke Program Early Computed Tomography Score: Is Modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3 Superior to mTICI 2b?
Sameh Samir ELAWADY ; Brian Fabian SAWAY ; Hidetoshi MATSUKAWA ; Kazutaka UCHIDA ; Steven LIN ; Ilko MAIER ; Pascal JABBOUR ; Joon-Tae KIM ; Stacey Quintero WOLFE ; Ansaar RAI ; Robert M. STARKE ; Marios-Nikos PSYCHOGIOS ; Edgar A SAMANIEGO ; Adam ARTHUR ; Shinichi YOSHIMURA ; Hugo CUELLAR ; Jonathan A. GROSSBERG ; Ali ALAWIEH ; Daniele G. ROMANO ; Omar TANWEER ; Justin MASCITELLI ; Isabel FRAGATA ; Adam POLIFKA ; Joshua OSBUN ; Roberto CROSA ; Charles MATOUK ; Min S. PARK ; Michael R. LEVITT ; Waleed BRINJIKJI ; Mark MOSS ; Travis DUMONT ; Richard WILLIAMSON JR. ; Pedro NAVIA ; Peter KAN ; Reade De LEACY ; Shakeel CHOWDHRY ; Mohamad EZZELDIN ; Alejandro M. SPIOTTA ; Sami Al KASAB ;
Journal of Stroke 2024;26(1):95-103
Background:
and Purpose Outcomes following mechanical thrombectomy (MT) are strongly correlated with successful recanalization, traditionally defined as modified Thrombolysis in Cerebral Infarction (mTICI) ≥2b. This retrospective cohort study aimed to compare the outcomes of patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS; 2–5) who achieved mTICI 2b versus those who achieved mTICI 2c/3 after MT.
Methods:
This study utilized data from the Stroke Thrombectomy and Aneurysm Registry (STAR), which combined databases from 32 thrombectomy-capable stroke centers between 2013 and 2023. The study included only patients with low ASPECTS who achieved mTICI 2b, 2c, or 3 after MT for internal carotid artery or middle cerebral artery (M1) stroke.
Results:
Of the 10,229 patients who underwent MT, 234 met the inclusion criteria. Of those, 98 (41.9%) achieved mTICI 2b, and 136 (58.1%) achieved mTICI 2c/3. There were no significant differences in baseline characteristics between the two groups. The 90-day favorable outcome (modified Rankin Scale score: 0–3) was significantly better in the mTICI 2c/3 group than in the mTICI 2b group (adjusted odds ratio 2.35; 95% confidence interval [CI] 1.18–4.81; P=0.02). Binomial logistic regression revealed that achieving mTICI 2c/3 was significantly associated with higher odds of a favorable 90-day outcome (odds ratio 2.14; 95% CI 1.07–4.41; P=0.04).
Conclusion
In patients with low ASPECTS, achieving an mTICI 2c/3 score after MT is associated with a more favorable 90-day outcome. These findings suggest that mTICI 2c/3 is a better target for MT than mTICI 2b in patients with low ASPECTS.
Result Analysis
Print
Save
E-mail