TY - JOUR
T1 - Thrombectomy in stroke patients with low alberta stroke program early computed tomography score
T2 - Is modified thrombolysis in cerebral infarction (mtici) 2c/3 superior to mtici 2b?
AU - STAR Collaborators
AU - Elawady, Sameh Samir
AU - Saway, Brian Fabian
AU - Matsukawa, Hidetoshi
AU - Uchida, Kazutaka
AU - Lin, Steven
AU - Maier, Ilko
AU - Jabbour, Pascal
AU - Kim, Joon Tae
AU - Wolfe, Stacey Quintero
AU - Rai, Ansaar
AU - Starke, Robert M.
AU - Psychogios, Marios Nikos
AU - Samaniego, Edgar A.
AU - Arthur, Adam
AU - Yoshimura, Shinichi
AU - Cuellar, Hugo
AU - Grossberg, Jonathan A.
AU - Alawieh, Ali
AU - Romano, Daniele G.
AU - Tanweer, Omar
AU - Mascitelli, Justin
AU - Fragata, Isabel
AU - Polifka, Adam
AU - Osbun, Joshua
AU - Crosa, Roberto
AU - Matouk, Charles
AU - Park, Min S.
AU - Levitt, Michael R.
AU - Brinjikji, Waleed
AU - Moss, Mark
AU - Dumont, Travis
AU - Williamson, Richard
AU - Navia, Pedro
AU - Kan, Peter
AU - De Leacy, Reade
AU - Chowdhry, Shakeel
AU - Ezzeldin, Mohamad
AU - Spiotta, Alejandro M.
AU - Al Kasab, Sami
N1 - Publisher Copyright:
© 2024 Korean Stroke Society.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - 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.
AB - 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.
KW - Alberta Stroke Program Early Computed Tomography Score
KW - Modified Thrombolysis in Cerebral Infarction
KW - Recanalization
KW - Stroke
KW - Thrombectomy
UR - http://www.scopus.com/inward/record.url?scp=85186406831&partnerID=8YFLogxK
U2 - 10.5853/jos.2023.02292
DO - 10.5853/jos.2023.02292
M3 - Article
C2 - 38326708
AN - SCOPUS:85186406831
SN - 2287-6391
VL - 26
SP - 95
EP - 103
JO - Journal of Stroke
JF - Journal of Stroke
IS - 1
ER -