PMID- 26888952
OWN - NLM
STAT- MEDLINE
DCOM- 20170327
LR  - 20220331
IS  - 1759-8486 (Electronic)
IS  - 1759-8478 (Linking)
VI  - 9
IP  - 2
DP  - 2017 Feb
TI  - Time to redefine success? TICI 3 versus TICI 2b recanalization in middle cerebral 
      artery occlusion treated with thrombectomy.
PG  - 117-121
LID - 10.1136/neurintsurg-2015-012218 [doi]
AB  - BACKGROUND: The Thrombolysis in Cerebral Infarction (TICI) scale is the most 
      widely applied scoring system to grade technical results of recanalizing 
      therapies in acute ischemic stroke (AIS). TICI 2b and TICI 3 are conventionally 
      subsumed as 'successful recanalization'. Previous studies reported conflicting 
      results for the clinical relevance of achieving complete (TICI 3) versus 'almost' 
      complete reperfusion (TICI 2b). OBJECTIVE: To examine if neurologic outcome 
      differs significantly between TICI 2b and TICI 3 in patients with AIS with middle 
      cerebral artery (MCA) occlusion treated 'successfully' with mechanical 
      thrombectomy (MTE). METHODS: Retrospective analysis of prospectively collected 
      data from 352 consecutive patients with isolated MCA occlusion subjected to MTE 
      between January 2007 and July 2015. RESULTS: 262 of the 277 successfully treated 
      patients had adequate follow-up and were included. Patients (n=119) in the TICI 3 
      group had a lower National Institutes of Health Stroke Scale score at discharge 
      (NIHSS-DIS; median 5 vs 7, p=0.005), and showed higher rates of strong neurologic 
      improvement (DeltaNIHSS>/=8 or NIHSS-DIS</=1, 68.4% vs 37.1%, p=0.002) and favorable 
      NIHSS outcome (NIHSS-DIS</=5, 49.2% vs 31.9%, p=0.005). Hospital stays were shorter 
      in the TICI 3 group (median 10 vs 12 days, p=0.014). After adjusting for relevant 
      baseline and treatment parameters, TICI 3 was independently associated with 
      strong neurologic improvement (OR=4.3, 95% CI 2.2 to 8.3, p<0.001) and favorable 
      NIHSS outcome (OR=3.0, 95% CI 1.5 to 6.3, p=0.003). CONCLUSIONS: Neurologic 
      outcome is substantially better in TICI 3 than TICI 2b patients, and hospital 
      stays are shorter. Endovascular strategies that consequently strive to achieve 
      TICI 3 may be warranted and cost-effective, and should be examined by future 
      research. TICI 3 rates should be included as a safety measure in studies 
      evaluating MTE devices and techniques.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/.
FAU - Kleine, Justus F
AU  - Kleine JF
AUID- ORCID: 0000-0002-2803-075X
AD  - Abteilung fur diagnostische und interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
FAU - Wunderlich, Silke
AU  - Wunderlich S
AD  - Neurologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische 
      Universitat Munchen, Munich, Germany.
FAU - Zimmer, Claus
AU  - Zimmer C
AD  - Abteilung fur diagnostische und interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
FAU - Kaesmacher, Johannes
AU  - Kaesmacher J
AD  - Abteilung fur diagnostische und interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
LA  - eng
PT  - Journal Article
DEP - 20160217
PL  - England
TA  - J Neurointerv Surg
JT  - Journal of neurointerventional surgery
JID - 101517079
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiography, Digital Subtraction
MH  - Brain Ischemia/diagnostic imaging/surgery
MH  - Cerebral Angiography
MH  - Cerebrovascular Circulation
MH  - Endovascular Procedures/methods
MH  - Female
MH  - Humans
MH  - Infarction, Middle Cerebral Artery/diagnostic imaging/*surgery
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Retrospective Studies
MH  - Stroke/diagnostic imaging/surgery
MH  - Thrombectomy/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Stroke
OT  - Thrombectomy
EDAT- 2016/02/19 06:00
MHDA- 2017/03/28 06:00
CRDT- 2016/02/19 06:00
PHST- 2015/12/03 00:00 [received]
PHST- 2016/01/13 00:00 [revised]
PHST- 2016/01/25 00:00 [accepted]
PHST- 2016/02/19 06:00 [pubmed]
PHST- 2017/03/28 06:00 [medline]
PHST- 2016/02/19 06:00 [entrez]
AID - neurintsurg-2015-012218 [pii]
AID - 10.1136/neurintsurg-2015-012218 [doi]
PST - ppublish
SO  - J Neurointerv Surg. 2017 Feb;9(2):117-121. doi: 10.1136/neurintsurg-2015-012218. 
      Epub 2016 Feb 17.