2026-04-17T20:10:02Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/67032025-10-24T10:32:39Zcom_2072_378070com_2072_378040col_2072_378092

Benchmarking the Extent and Speed of Reperfusion: First Pass TICI 2c-3 Is a Preferred Endovascular Reperfusion Endpoint Yoo, Albert J. Soomro, Jazba Andersson, Tommy Saver, Jeffrey L. Ribó Jacobi, Marc Bozorgchami, Hormozd Institut Català de la Salut [Yoo AJ, Soomro J] Department of Neurointervention, Texas Stroke Institute, Fort Worth, TX, United States. [Andersson T] Neuroradiology, Karolinska University Hospital, Clinical Neuroscience Karolinska Institutet, Stockholm, Sweden. Medical Imaging, Allgemeine Ziekenhuis Groeninge, Kortrijk, Belgium. [Saver JL] Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States. [Ribo M] Unitat d’Ictus, Servei de Neurologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Bozorgchami H] Department of Neurology, Oregon Health and Science University Hospital, Portland, OR, United States Vall d'Hebron Barcelona Hospital Campus Isquèmia cerebral - Tractament Reperfusió (Fisiologia) DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia Other subheadings::Other subheadings::/therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Perfusion::Reperfusion Other subheadings::Other subheadings::/methods ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral Otros calificadores::Otros calificadores::/terapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::perfusión::reperfusión Otros calificadores::Otros calificadores::/métodos Isquèmia cerebral; Trombectomia mecànica; Reperfusió Isquemia cerebral; Trombectomía mecánica; Reperfusión Brain ischaemia; Mechanical thrombectomy; Reperfusion Background and Purpose: End-of-procedure substantial reperfusion [modified Treatment in Cerebral Ischemia (mTICI) 2b-3], the leading endpoint for thrombectomy studies, has several limitations including a ceiling effect, with recent achieved rates of ~90%. We aimed to identify a more optimal definition of angiographic success along two dimensions: (1) the extent of tissue reperfusion, and (2) the speed of revascularization. Methods: Core-lab adjudicated TICI scores for the first three passes of EmboTrap and the final all-procedures result were analyzed in the ARISE II multicenter study. The clinical impact of extent of reperfusion and speed of reperfusion (first-pass vs. later-pass) were evaluated. Clinical outcomes included 90-day functional independence [modified Rankin Scale (mRS) 0–2], 90-day freedom-from-disability (mRS 0–1), and dramatic early improvement [24-h National Institutes of Health Stroke Scale (NIHSS) improvement ≥ 8 points]. Results: Among 161 ARISE II subjects with ICA or MCA M1 occlusions, reperfusion results at procedure end showed substantial reperfusion in 149 (92.5%), excellent reperfusion in 121 (75.2%), and complete reperfusion in 79 (49.1%). Reperfusion rates on first pass were substantial in 81 (50.3%), excellent reperfusion in 62 (38.5%), and complete reperfusion in 44 (27.3%). First-pass excellent reperfusion (first-pass TICI 2c-3) had the greatest nominal predictive value for 90-day mRS 0–2 (sensitivity 58.5%, specificity 68.6%). There was a progressive worsening of outcomes with each additional pass required to achieve TICI 2c-3. Conclusions: First-pass excellent reperfusion (TICI 2c-3), reflecting rapid achievement of extensive reperfusion, is the technical revascularization endpoint that best predicted functional independence in this international multicenter trial and is an attractive candidate for a lead angiographic endpoint for future trials. Cerenovus sponsored the ARISE II study, and provided support for open access to this article. 2021-12-16T13:20:21Z 2021-12-16T13:20:21Z 2021-05-11 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Yoo AJ, Soomro J, Andersson T, Saver JL, Ribo M, Bozorgchami H, et al. Benchmarking the Extent and Speed of Reperfusion: First Pass TICI 2c-3 Is a Preferred Endovascular Reperfusion Endpoint. Front Neurol. 2021 May 11;12:669934. 1664-2295 https://hdl.handle.net/11351/6703 10.3389/fneur.2021.669934 34046008 000653650500001 http://hdl.handle.net/11351/6703 eng Frontiers in Neurology;12 https://doi.org/10.3389/fneur.2021.669934 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf application/pdf application/pdf Frontiers Media Scientia