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Not all "successful" angiographic reperfusion patients are an equal validation of a modified TICI scoring system
MA. Almekhlafi, S. Mishra, JA. Desai, V. Nambiar, O. Volny, A. Goel, M. Eesa, AM. Demchuk, BK. Menon, M. Goyal,
Jazyk angličtina Země Itálie
Typ dokumentu hodnotící studie, časopisecké články, validační studie
NLK
Free Medical Journals
od 2008 do Před 1 rokem
PubMed Central
od 1999 do Před 1 rokem
Europe PubMed Central
od 1999 do Před 1 rokem
PubMed
24556296
DOI
10.15274/inr-2014-10004
Knihovny.cz E-zdroje
- MeSH
- cévní mozková příhoda epidemiologie radiografie chirurgie MeSH
- databáze faktografické MeSH
- hodnocení výsledků zdravotní péče metody statistika a číselné údaje MeSH
- lidé MeSH
- mechanická trombolýza statistika a číselné údaje MeSH
- mozková angiografie statistika a číselné údaje MeSH
- odchylka pozorovatele MeSH
- prevalence MeSH
- reprodukovatelnost výsledků MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- stupeň závažnosti nemoci * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- validační studie MeSH
- Geografické názvy
- Alberta MeSH
Rapid reperfusion of the entire territory distal to vascular occlusions is the aim of stroke interventions. Recent studies defined successful reperfusion as establishing some perfusion with distal branch filling of <50% of territory visualized (Thrombolysis In Cerebral Infarction "TICI" 2a) or more. We investigate the importance of the quality of final reperfusion and whether a revision of the successful reperfusion definition is warranted. We retrospectively evaluated a prospective database of anterior circulation strokes treated using stentrievers to assess the quality of final reperfusion using two scores: the traditional TICI score and a modified TICI score. The modified TICI score includes an additional category (TICI 2c): near complete perfusion except for slow flow or distal emboli in a few distal cortical vessels. We compared different cut-off definitions of reperfusion (TICI 2a - 3 vs. TICI-2b-3 vs. TICI 2c-3) using the area under the curve to identify their correlation with a favorable 90-day outcome (mRS≤2). In our cohort of 110 patients, 90% achieved TICI 2a-3 reperfusion with 80% achieving TICI 2b-3 and 55.5% achieving TICI 2c-3. The proportion of patients with a favorable 90-day outcome was higher in the TICI 2c (62.5%) compared to TICI 2b (44.4%) or TICI 2a (45.5%) but similar to the TICI 3 group (75.9%). A TICI 2c-3 reperfusion had a better predictive value than TICI 2b-3 for 90-day mRS 0-1. Defining successful reperfusion as TICI 2c/3 has merits. In this cohort, there was evidence toward faster recovery and better outcomes in patients with the TICI 2c vs. the traditional TICI 2b grade.
Calgary Canada 1st Neurological Clinic and International Clinical Research Centre
Calgary Canada Department of Community Health Sciences University of Calgary
Calgary Canada Department of Internal Medicine King Abdulaziz University
Calgary Canada Department of Radiology University of Calgary
Calgary Canada Hotchkiss Brain Institute
Calgary Stroke Program Department of Clinical Neurosciences University of Calgary
Citace poskytuje Crossref.org
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