Impact of Modified TICI 3 versus Modified TICI 2b Reperfusion Score to Predict Good Outcome following Endovascular Therapy.
Cyril Dargazanli,Arturo Consoli,M. Barral,Julien Labreuche,Hocine Redjem,Gabriele Ciccio,Stanislas Smajda,Jean-Philippe Desilles,Guillaume Taylor,Cristian Preda,Oguzhan Coskun,G. Rodesch,Michel Piotin,Raphaël Blanc,Bertrand Lapergue +14 more
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TLDR
Given the improving reperfusion rates obtained with thrombectomy devices, future thromBectomy trials should consider modified TicI 2b and modified TICI 3 status separately.Abstract:
BACKGROUND AND PURPOSE: The TICI score is widely used to evaluate cerebral perfusion before and after the endovascular treatment of stroke. Recent studies showing the effectiveness and safety of mechanical thrombectomy combine modified TICI 2b and modified TICI 3 to assess the technical success of endovascular treatment. The purpose of this study was to determine how much clinical outcomes differ between patients achieving modified TICI 2b and modified TICI 3 reperfusion. MATERIALS AND METHODS: We analyzed 222 consecutive patients with acute large intracranial artery occlusion of the anterior circulation having achieved modified TICI 2b or modified TICI 3 reperfusion after thrombectomy. The primary end point was the rate of favorable outcome defined as the achievement of a modified Rankin Scale score of 0–2 at 3 months. RESULTS: Patients with modified TICI 3 more often had favorable collateral circulation and atherosclerosis etiology, with a shorter time from onset to reperfusion than patients with modified TICI 2b (all P CONCLUSIONS: Patients with modified TICI 3 reperfusion have better functional outcomes than those with modified TICI 2b. Given the improving reperfusion rates obtained with thrombectomy devices, future thrombectomy trials should consider modified TICI 2b and modified TICI 3 status separately.read more
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Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER Randomized Clinical Trial.
Bertrand Lapergue,Raphaël Blanc,Benjamin Gory,Julien Labreuche,Alain Duhamel,Gaultier Marnat,Suzana Saleme,Vincent Costalat,Serge Bracard,Hubert Desal,Mikael Mazighi,Arturo Consoli,Michel Piotin +12 more
TL;DR: Among patients with ischemic stroke in the anterior circulation undergoing thrombectomy, first-line throm bectomy with contact aspiration compared with stent retriever did not result in an increased successful revascularization rate at the end of the procedure.
Journal ArticleDOI
First Pass Effect: A New Measure for Stroke Thrombectomy Devices.
Osama O. Zaidat,Alicia C. Castonguay,Italo Linfante,Rishi Gupta,C Martin,William E. Holloway,Nils Mueller-Kronast,Joey English,Guilherme Dabus,Tim W. Malisch,Franklin A. Marden,Hormozd Bozorgchami,Andrew R. Xavier,Ansaar T Rai,Michael T. Froehler,Aamir Badruddin,Thanh N. Nguyen,M. Asif Taqi,Michael G. Abraham,Albert J. Yoo,Vallabh Janardhan,Hashem Shaltoni,Roberta Novakovic,Alex Abou-Chebl,Peng R. Chen,Gavin W. Britz,Chung Huan J Sun,Vibhav Bansal,Ritesh Kaushal,Ashish Nanda,Raul G. Nogueira +30 more
TL;DR: The achievement of complete revascularization from a single Solitaire thrombectomy device pass (FPE) is associated with significantly higher rates of good clinical outcome and the FPE is more frequently associated with the use of balloon guide catheters and less likely to be achieved with internal carotid artery terminus occlusion.
Journal ArticleDOI
eTICI reperfusion: defining success in endovascular stroke therapy
David S Liebeskind,Serge Bracard,Serge Bracard,Francis Guillemin,Francis Guillemin,Reza Jahan,Tudor G Jovin,Charles B. L. M. Majoie,Peter Mitchell,Aad van der Lugt,Bijoy K Menon,Luis San Roman,Bruce C.V. Campbell,Keith W. Muir,Michael D. Hill,Diederik W.J. Dippel,Jeffrey L. Saver,Andrew M. Demchuk,Antoni Dávalos,Philip White,Scott Brown,Mayank Goyal +21 more
TL;DR: The benefit of endovascular therapy in HERMES was strongly associated with increasing degrees of reperfusion defined by eTICI, which identified meaningful distinctions in clinical outcomes and may be used in future studies and routine practice.
Journal ArticleDOI
Modified Thrombolysis in Cerebral Infarction 2C/Thrombolysis in Cerebral Infarction 3 Reperfusion Should Be the Aim of Mechanical Thrombectomy: Insights From the ASTER Trial (Contact Aspiration Versus Stent Retriever for Successful Revascularization)
Cyril Dargazanli,Robert Fahed,Raphaël Blanc,Benjamin Gory,Julien Labreuche,Alain Duhamel,Gaultier Marnat,Suzana Saleme,Vincent Costalat,Serge Bracard,Hubert Desal,Mikael Mazighi,Arturo Consoli,Michel Piotin,Bertrand Lapergue +14 more
TL;DR: A subgroup of patients achieving better functional outcomes than mTICI 2B patients should be the new aim of mechanical thrombectomy for anterior circulation LVO, according to the results of an ancillary study from the ASTER prospective multicenter blinded end point trial.
Journal ArticleDOI
Mechanical thrombectomy in basilar artery occlusion: influence of reperfusion on clinical outcome and impact of the first-line strategy (ADAPT vs stent retriever).
Benjamin Gory,Mikael Mazighi,Raphaël Blanc,Julien Labreuche,Michel Piotin,Francis Turjman,Bertrand Lapergue +6 more
TL;DR: Mmong BAO patients, successful reperfusion is a strong predictor of a 90-day favorable outcome, and the choice of ADAPT as the first-line strategy achieves a significantly higher rate of complete reperfusions with a shorter procedure duration.
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