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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorYoo, Albert J.
dc.contributor.authorSoomro, Jazba
dc.contributor.authorAndersson, Tommy
dc.contributor.authorSaver, Jeffrey L.
dc.contributor.authorRibó Jacobi, Marc
dc.contributor.authorBozorgchami, Hormozd
dc.date.accessioned2021-12-16T13:20:21Z
dc.date.available2021-12-16T13:20:21Z
dc.date.issued2021-05-11
dc.identifier.citationYoo AJ, Soomro J, Andersson T, Saver JL, Ribo M, Bozorgchami H, et al. Benchmarking the Extent and Speed of Reperfusion: First Pass TICI 2c-3 Is a Preferred Endovascular Reperfusion Endpoint. Front Neurol. 2021 May 11;12:669934.
dc.identifier.issn1664-2295
dc.identifier.urihttp://hdl.handle.net/11351/6703
dc.descriptionBrain ischaemia; Mechanical thrombectomy; Reperfusion
dc.description.abstractBackground and Purpose: End-of-procedure substantial reperfusion [modified Treatment in Cerebral Ischemia (mTICI) 2b-3], the leading endpoint for thrombectomy studies, has several limitations including a ceiling effect, with recent achieved rates of ~90%. We aimed to identify a more optimal definition of angiographic success along two dimensions: (1) the extent of tissue reperfusion, and (2) the speed of revascularization. Methods: Core-lab adjudicated TICI scores for the first three passes of EmboTrap and the final all-procedures result were analyzed in the ARISE II multicenter study. The clinical impact of extent of reperfusion and speed of reperfusion (first-pass vs. later-pass) were evaluated. Clinical outcomes included 90-day functional independence [modified Rankin Scale (mRS) 0–2], 90-day freedom-from-disability (mRS 0–1), and dramatic early improvement [24-h National Institutes of Health Stroke Scale (NIHSS) improvement ≥ 8 points]. Results: Among 161 ARISE II subjects with ICA or MCA M1 occlusions, reperfusion results at procedure end showed substantial reperfusion in 149 (92.5%), excellent reperfusion in 121 (75.2%), and complete reperfusion in 79 (49.1%). Reperfusion rates on first pass were substantial in 81 (50.3%), excellent reperfusion in 62 (38.5%), and complete reperfusion in 44 (27.3%). First-pass excellent reperfusion (first-pass TICI 2c-3) had the greatest nominal predictive value for 90-day mRS 0–2 (sensitivity 58.5%, specificity 68.6%). There was a progressive worsening of outcomes with each additional pass required to achieve TICI 2c-3. Conclusions: First-pass excellent reperfusion (TICI 2c-3), reflecting rapid achievement of extensive reperfusion, is the technical revascularization endpoint that best predicted functional independence in this international multicenter trial and is an attractive candidate for a lead angiographic endpoint for future trials.
dc.language.isoeng
dc.publisherFrontiers Media
dc.relation.ispartofseriesFrontiers in Neurology;12
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectIsquèmia cerebral - Tractament
dc.subjectReperfusió (Fisiologia)
dc.subject.meshBrain Ischemia
dc.subject.mesh/therapy
dc.subject.meshReperfusion
dc.subject.mesh/methods
dc.titleBenchmarking the Extent and Speed of Reperfusion: First Pass TICI 2c-3 Is a Preferred Endovascular Reperfusion Endpoint
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.3389/fneur.2021.669934
dc.subject.decsisquemia cerebral
dc.subject.decs/terapia
dc.subject.decsreperfusión
dc.subject.decs/métodos
dc.relation.publishversionhttps://doi.org/10.3389/fneur.2021.669934
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Yoo AJ, Soomro J] Department of Neurointervention, Texas Stroke Institute, Fort Worth, TX, United States. [Andersson T] Neuroradiology, Karolinska University Hospital, Clinical Neuroscience Karolinska Institutet, Stockholm, Sweden. Medical Imaging, Allgemeine Ziekenhuis Groeninge, Kortrijk, Belgium. [Saver JL] Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States. [Ribo M] Unitat d’Ictus, Servei de Neurologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Bozorgchami H] Department of Neurology, Oregon Health and Science University Hospital, Portland, OR, United States
dc.identifier.pmid34046008
dc.identifier.wos000653650500001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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