E-029 Thrombectomy in stroke patients with low ASPECTS: is TICI 2C/3 superior to TICI 2B?

S Elawady; M Mahdi Sowlat; I Maier; P Jabbour; J Kim; S Quintero Wolfe; A Rai; R Starke; M Psychogios; E Samaniego; A Arthur; S Yoshimura; J A Grossberg; A Alawieh; J Mascitelli; I Fragata; H Cuellar; A Polifka; J Osbun; R Crosa; C Matouk; M S Park; M Levitt; W Brinjikji; T Dumont; R Williamson; P Navia; A Spiotta; S Al Kasab

doi:10.1136/jnis-2023-SNIS.129

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E-029 Thrombectomy in stroke patients with low ASPECTS: is TICI 2C/3 superior to TICI 2B?

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E-029 Thrombectomy in stroke patients with low ASPECTS: is TICI 2C/3 superior to TICI 2B?

S Elawady, M Mahdi Sowlat, I Maier, P Jabbour, J Kim, S Quintero Wolfe, A Rai, R Starke, M Psychogios, E Samaniego, …

Journal of neurointerventional surgery, Vol.15(Suppl 1), pp.A92-A93

07/01/2023

DOI: 10.1136/jnis-2023-SNIS.129

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Abstract

Introduction/Purpose the procedural success of mechanical thrombectomy (MT) has been traditionally defined by a final thrombolysis in cerebral infarction (TICI) score of 2B/3. However, several studies have shown that patients with a TICI score of 2C and 3 have a significantly better outcome than those with a TICI score of 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 TICI 2B versus those who achieved TICI 2C/3 after MT in the early and late time window periods. 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 TICI 2B, 2C, or 3 after MT for internal carotid artery (ICA) or middle cerebral artery (M1) stroke. Results Of the 10,081 patients who underwent MT, 309 met the inclusion criteria. Of these, 138 (44.6%) achieved TICI 2B, and 171 (55.4%) achieved TICI 2C/3. There were no significant differences in baseline characteristics between the two groups. The 90-day favorable outcome (Modified Rankin Score [mRS]: 0-3) was significantly better in the TICI 2C/3 group than in the TICI 2B group (42.0% versus 25.4%; P=0.047). After adjusting for Age, NIHSS, intravenous tPA administration, total attempts, distal embolization, successful recanalization, symptoms onset to groin puncture, and ICA involvement, binary regression analysis revealed that achieving TICI 2C/3 was significantly associated with higher odds of a favorable 90-day outcome (OR 3.30; 95% CI 1.24-9.51; P=0.02). Conclusion In patients with low ASPECTS, achieving a TICI 2C/3 score after MT is associated with a more favorable 90-day outcome. These findings suggest that TICI 2C/3 is a better target for MT than TICI 2B in patients with low ASPECTS.Abstract E-029 Figure 1 Disclosures S. Samir Elawady: None. M. Mahdi Sowlat: None. I. Maier: None. P. Jabbour: None. J. Kim: None. S. Quintero Wolfe: None. A. Rai: None. R. M Starke: None. M. Psychogios: None. E. Samaniego: None. A. Arthur: None. S. Yoshimura: None. J. A. Grossberg: None. A. Alawieh: None. J. Mascitelli: None. I. Fragata: None. H. Cuellar: None. A. Polifka: None. J. Osbun: None. R. Crosa: None. C. Matouk: None. M. S. Park: None. M. R. Levitt: None. W. Brinjikji: None. T. Dumont: None. R. Williamson Jr: None. P. Navia: None. A. M Spiotta: None. S. Al Kasab: None.

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Title: Subtitle: E-029 Thrombectomy in stroke patients with low ASPECTS: is TICI 2C/3 superior to TICI 2B?
Creators: S Elawady - Medical University of South Carolina
M Mahdi Sowlat - Medical University of South Carolina
I Maier - Universitätsmedizin Göttingen
P Jabbour - Thomas Jefferson University
J Kim - Chonnam National University Hospital
S Quintero Wolfe
A Rai - West Virginia University
R Starke - University of Miami Health System
M Psychogios - University Hospital of Basel
E Samaniego - University of Iowa
A Arthur - Semmes Murphey Foundation
S Yoshimura - Hyogo Medical University
J A Grossberg - Emory University
A Alawieh - Emory University
J Mascitelli - The University of Texas Health Science Center at San Antonio
I Fragata - Unidade Local de Saúde de São José
H Cuellar - Louisiana State University Health Sciences Center Shreveport
A Polifka - University of Florida
J Osbun - Washington University in St. Louis
R Crosa - Administracion de los Servicios de Salud del Estado
C Matouk - Yale University
M S Park - University of Virginia
M Levitt - University of Washington
W Brinjikji - Mayo Clinic in Arizona
T Dumont - University of Arizona
R Williamson - Alleghany County Schools
P Navia - Hospital Universitario La Paz
A Spiotta - Medical University of South Carolina
S Al Kasab - Medical University of South Carolina
Resource Type: Abstract
Publication Details: Journal of neurointerventional surgery, Vol.15(Suppl 1), pp.A92-A93
DOI: 10.1136/jnis-2023-SNIS.129
ISSN: 1759-8478
eISSN: 1759-8486
Publisher: BMJ Publishing Group LTD
Language: English
Date published: 07/01/2023
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984453332002771

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