Prediction of mTICI 3 recanalization and clinical outcomes in endovascular thrombectomy for acute ischemic stroke: a ret
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ORIGINAL ARTICLE
Prediction of mTICI 3 recanalization and clinical outcomes in endovascular thrombectomy for acute ischemic stroke: a retrospective study in the Taiwan registry Ching-Chung Ko 1,2 & Hon-Man Liu 3,4 & Tai-Yuan Chen 1,5 & Te-Chang Wu 1,5,6 & Li-Kai Tsai 7 & Sung-Chun Tang 7 & Yu-Kun Tsui 1 & Jiann-Shing Jeng 7 Received: 27 April 2020 / Accepted: 5 October 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Purpose Early recanalization for acute ischemic stroke (AIS) due to large vessel occlusion (LVO) by endovascular thrombectomy (EVT) is strongly related to improved functional outcomes. With data obtained from the Taiwan registry, the factors associated with mTICI 3 recanalization and clinical outcomes in EVT are investigated. Methods From January 2014 to September 2016, 108 patients who underwent EVT for AIS due to LVO in 11 medical centers throughout Taiwan were included. Complete recanalization is defined as achieving modified thrombolysis in cerebral infarction (mTICI) grade 3. Good clinical outcomes are defined by the modified Rankin scale (mRS) 0–2 at 3 months after EVT. Clinical and imaging parameters for predicting mTICI 3 recanalization and good clinical outcomes are analyzed. Results Of the 108 patients who received EVT, 54 (50%) patients had mTICI 3 recanalization. Having received aspiration only and the use of IV-tPA are shown to be significant predictors for mTICI 3 recanalization with odds ratios of 2.61 and 2.53 respectively. Forty-six (42.6%) patients experienced good 3-month clinical outcomes (mRS 0–2). Pretreatment collateral statuses, NIHSS scores, time lapses between symptoms to needle, and the occurrence of hemorrhage at 24 h are all significant predictors for good outcomes with odds ratios of 2.88, 0.91, 0.99, and 0.31 respectively. Conclusions Prediction of mTICI 3 recanalization and clinical outcomes offer valuable clinical information for treatment planning in EVT. Keywords Acute ischemic stroke . Large vessel occlusion . Endovascular thrombectomy . Recanalization . Outcome
* Yu-Kun Tsui [email protected]
1
Department of Medical Imaging, Chi Mei Medical Center, No.901, Zhonghua Rd., Yongkang District, Tainan City 71004, Taiwan, Republic of China
Ching-Chung Ko [email protected]
2
Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
Hon-Man Liu [email protected]
3
Department of Medical Imaging, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No.69, Guizi Rd., Taishan Dist, New Taipei City 24352, Taiwan, Republic of China
4
Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
5
Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan
6
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
7
Stroke Center and Department of Neurology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei City 100, Taiwan
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