Journal article
Complete reperfusion is required for maximal benefits of mechanical thrombectomy in stroke patients
Scientific reports, Vol.7(1), pp.11636-7
09/14/2017
DOI: 10.1038/s41598-017-11946-y
PMCID: PMC5599658
PMID: 28912596
Abstract
A mTICI 2b or a mTICI 3 score are currently considered success following mechanical thrombectomy (MT) in acute stroke but is undetermined whether the two scores translate equivalent outcomes. We present a single-center, retrospective cohort of patients with anterior circulation stroke treated with MT and achieving a final mTICI score 2b or 3. A multimodal CT at baseline and a multimodal MRI at 24 hours assessed the growth of the infarct, and the modified Rankin Scale (mRS) assessed functional outcome at 90 days. The primary outcome was the shift analysis of the mRS at day 90 in ordinal regression adjusted for covariates (age, sex, pretreatment NIHSS score, target occlusion, infarct core, pretreatment alteplase), and the collateral score. Infarct growth was explored in a similarly adjusted multiple linear regression model. MT was started within a median of 285 minutes of symptom onset; 51 (41%) patients achieved a mTICI 2b, and 74 (59%), a mTICI 3. mTICI 3 resulted in better mRS score transitions than mTICI 2b (odds ratio 2.018 [95% CI 1.033-3.945], p = 0. 040), and reduced infarct growth (p = 0.002). We conclude that in patients with acute stroke receiving MT, success should be redefined as achieving a mTICI 3 score.
Details
- Title: Subtitle
- Complete reperfusion is required for maximal benefits of mechanical thrombectomy in stroke patients
- Creators
- Ángel Chamorro - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain. achamorro@clinic.ub.esJordi Blasco - Radiology Department, Hospital Clinic, Barcelona, SpainAntonio López - Radiology Department, Hospital Clinic, Barcelona, SpainSergio Amaro - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, SpainLuis San Román - Radiology Department, Hospital Clinic, Barcelona, SpainLaura Llull - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, SpainArturo Renú - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, SpainSalvatore Rudilosso - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, SpainCarlos Laredo - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, SpainVictor Obach - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, SpainXabier Urra - Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, SpainAnna M Planas - Department of Brain Ischemia and Neurodegeneration, Institute for Biomedical Research of Barcelona, Spanish Research Council, Barcelona, Spain, IDIBAPS, Barcelona, SpainEnrique C Leira - Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USAJuan Macho - Radiology Department, Hospital Clinic, Barcelona, Spain
- Resource Type
- Journal article
- Publication Details
- Scientific reports, Vol.7(1), pp.11636-7
- DOI
- 10.1038/s41598-017-11946-y
- PMID
- 28912596
- PMCID
- PMC5599658
- NLM abbreviation
- Sci Rep
- ISSN
- 2045-2322
- eISSN
- 2045-2322
- Publisher
- England
- Language
- English
- Date published
- 09/14/2017
- Academic Unit
- Neurology; Epidemiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984070365802771