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?
2024 | journal article. A publication with affiliation to the University of Göttingen.
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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?
Elawady, S. S.; Saway, B. F.; Matsukawa, H.; Uchida, K.; Lin, S.; Maier, I. & Jabbour, P. et al. (2024)
Journal of Stroke, 26(1) pp. 95-103. DOI: https://doi.org/10.5853/jos.2023.02292
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Details
- Authors Group
- on behalf of the STAR Collaborators
The authors list is uncomplete: - Authors
- Elawady, Sameh Samir; Saway, Brian Fabian; Matsukawa, Hidetoshi; Uchida, Kazutaka; Lin, Steven; Maier, Ilko; Jabbour, Pascal; Kim, Joon-Tae; Wolfe, Stacey Quintero; Rai, Ansaar; Kasab, Sami Al
- Abstract
- 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; <i>P</i>=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; <i>P</i>=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.
- Issue Date
- 2024
- Journal
- Journal of Stroke
- ISSN
- 2287-6391
- eISSN
- 2287-6405
- Language
- English