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Correlation of AOL recanalization, TIMI reperfusion and TICI reperfusion with infarct growth and clinical outcome.

Abstract：

OBJECTIVE:To understand how three commonly used measures of endovascular therapy correlate with clinical outcome and infarct growth. METHODS:Prospectively enrolled patients underwent baseline MRI and started endovascular therapy within 12 h of stroke onset. The final angiogram was given a primary arterial occlusive lesion (AOL) recanalization score (0-3), a Thrombolysis in Myocardial Infarction (TIMI) score (0-3) and a Thrombolysis in Cerebral Infarction (TICI) score (0-3). The scores were dichotomized into poor revascularization (AOL 0-2, TIMI 0-1 and TICI 0-2a) versus good revascularization (AOL 3, TIMI 2-3, TICI 2b-3). Patients were classified according to whether or not they had target mismatch (TMM). Good outcome was defined as a 90-day modified Rankin Scale score of 0-2. RESULTS:Endovascular treatment was attempted in 100. A good outcome was achieved in 57% of patients with a TICI score of 2b-3 and in 24% of patients with a TICI score of 0-2a (p=0.001). Patients with TIMI scores of 2-3 and an AOL score of 3 had lower rates of good outcome (44% and 47%, respectively), which were not significantly better than those with TIMI scores of 0-1 or AOL scores of 0-2. In patients with TMM, these rates of good outcome improved with all the scoring systems and were significantly better for TIMI and TICI scores. Patients with a TICI score of 2a had rates of good functional outcome and lesion growth which were not different from those with TICI scores of 0-1 but were significantly worse than those with TICI scores of 2b-3. CONCLUSIONS:TIMI 2-3 and TICI 2b-3 reperfusion scores demonstrated improved outcome in patients with tissue mismatch with a small infarct core and a larger hypoperfused region but AOL scores did not. Patients with a TICI score of 2a had a poorer outcome and more lesion growth than those with TICI scores of 2b-3.

journal_name

J Neurointerv Surg

journal_title

Journal of neurointerventional surgery

authors

Marks MP,Lansberg MG,Mlynash M,Kemp S,McTaggart R,Zaharchuk G,Bammer R,Albers GW,DEFUSE 2 Investigators.

doi

10.1136/neurintsurg-2013-010973

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

724-8

issue

eissn

1759-8478

issn

1759-8486

pii

neurintsurg-2013-010973

journal_volume

pub_type

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Correlation of AOL recanalization, TIMI reperfusion and TICI reperfusion with infarct growth and clinical outcome.