Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomy
Abstract Objective For patients presenting with acute ischemic stroke (AIS) caused by large vessel occlusions (LVO), mechanical thrombectomy (MT) is the treatment standard of care in eligible patients. Modified Thrombolysis in Cerebral Infarction (mTICI) grades of 2b, 2c, and 3 are all considered su...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51935 |
| _version_ | 1827380527099805696 |
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| author | Richard Wang Jing Huang Alireza Mohseni Meisam Hoseinyazdi Apoorva Kotha Omar Hamam Julie Gudenkauf Hye Young Heo Mehreen Nabi Judy Huang Fernando Gonzalez Golnoosh Ansari Mahla Radmard Licia Luna Justin Caplan Risheng Xu Vivek Yedavalli |
| author_facet | Richard Wang Jing Huang Alireza Mohseni Meisam Hoseinyazdi Apoorva Kotha Omar Hamam Julie Gudenkauf Hye Young Heo Mehreen Nabi Judy Huang Fernando Gonzalez Golnoosh Ansari Mahla Radmard Licia Luna Justin Caplan Risheng Xu Vivek Yedavalli |
| author_sort | Richard Wang |
| collection | DOAJ |
| description | Abstract Objective For patients presenting with acute ischemic stroke (AIS) caused by large vessel occlusions (LVO), mechanical thrombectomy (MT) is the treatment standard of care in eligible patients. Modified Thrombolysis in Cerebral Infarction (mTICI) grades of 2b, 2c, and 3 are all considered successful reperfusion; however, recent studies have shown achieving mTICI 2c/3 leads to better outcomes than mTICI 2b. This study aims to investigate whether any baseline preprocedural or periprocedural parameters are predictive of achieving mTICI 2c/3 in successfully recanalized LVO patients. Methods We conducted a retrospective multicenter cohort study of consecutive patients presenting with AIS caused by a LVO from 1 January 2017 to 1 January 2023. Baseline and procedural data were collected through chart review. Univariate and multivariate analysis were applied to determine significant predictors of mTICI 2c/3. Results A total of 216 patients were included in the study, with 159 (73.6%) achieving mTICI 2c/3 recanalization and 57 (26.4%) achieving mTICI 2b recanalization. We found that a higher groin puncture to first pass time (OR = 0.976, 95%CI: 0.960–0.992, p = 0.004), a higher first pass to recanalization time (OR = 0.985, 95%CI: 0.972–0.998, p = 0.029), a higher admission NIHSS (OR = 0.949, 95%CI: 0.904–0.995, p = 0.031), and a lower age (OR = 1.032, 95%CI: 1.01–1.055, p = 0.005) were associated with a decreased probability of achieving mTICI 2c/3. Interpretation A lower groin puncture to first pass time, a lower first pass to recanalization time, a lower admission NIHSS, and a higher age were independent predictors of mTICI 2c/3 recanalization. |
| first_indexed | 2024-03-08T13:35:13Z |
| format | Article |
| id | doaj.art-3f58d9499df343598e725d8792cfe0af |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-03-08T13:35:13Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-3f58d9499df343598e725d8792cfe0af2024-01-16T18:36:37ZengWileyAnnals of Clinical and Translational Neurology2328-95032024-01-01111899510.1002/acn3.51935Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomyRichard Wang0Jing Huang1Alireza Mohseni2Meisam Hoseinyazdi3Apoorva Kotha4Omar Hamam5Julie Gudenkauf6Hye Young Heo7Mehreen Nabi8Judy Huang9Fernando Gonzalez10Golnoosh Ansari11Mahla Radmard12Licia Luna13Justin Caplan14Risheng Xu15Vivek Yedavalli16Department of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USASchool of Nursing Johns Hopkins University Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Neurosurgery Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Neurosurgery Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Neurosurgery Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Neurosurgery Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Radiology and Radiological Sciences, Division of Neuroradiology Johns Hopkins School of Medicine Baltimore Maryland USAAbstract Objective For patients presenting with acute ischemic stroke (AIS) caused by large vessel occlusions (LVO), mechanical thrombectomy (MT) is the treatment standard of care in eligible patients. Modified Thrombolysis in Cerebral Infarction (mTICI) grades of 2b, 2c, and 3 are all considered successful reperfusion; however, recent studies have shown achieving mTICI 2c/3 leads to better outcomes than mTICI 2b. This study aims to investigate whether any baseline preprocedural or periprocedural parameters are predictive of achieving mTICI 2c/3 in successfully recanalized LVO patients. Methods We conducted a retrospective multicenter cohort study of consecutive patients presenting with AIS caused by a LVO from 1 January 2017 to 1 January 2023. Baseline and procedural data were collected through chart review. Univariate and multivariate analysis were applied to determine significant predictors of mTICI 2c/3. Results A total of 216 patients were included in the study, with 159 (73.6%) achieving mTICI 2c/3 recanalization and 57 (26.4%) achieving mTICI 2b recanalization. We found that a higher groin puncture to first pass time (OR = 0.976, 95%CI: 0.960–0.992, p = 0.004), a higher first pass to recanalization time (OR = 0.985, 95%CI: 0.972–0.998, p = 0.029), a higher admission NIHSS (OR = 0.949, 95%CI: 0.904–0.995, p = 0.031), and a lower age (OR = 1.032, 95%CI: 1.01–1.055, p = 0.005) were associated with a decreased probability of achieving mTICI 2c/3. Interpretation A lower groin puncture to first pass time, a lower first pass to recanalization time, a lower admission NIHSS, and a higher age were independent predictors of mTICI 2c/3 recanalization.https://doi.org/10.1002/acn3.51935 |
| spellingShingle | Richard Wang Jing Huang Alireza Mohseni Meisam Hoseinyazdi Apoorva Kotha Omar Hamam Julie Gudenkauf Hye Young Heo Mehreen Nabi Judy Huang Fernando Gonzalez Golnoosh Ansari Mahla Radmard Licia Luna Justin Caplan Risheng Xu Vivek Yedavalli Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomy Annals of Clinical and Translational Neurology |
| title | Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomy |
| title_full | Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomy |
| title_fullStr | Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomy |
| title_full_unstemmed | Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomy |
| title_short | Predictors of mTICI 2c/3 over 2b in patients successfully recanalized with mechanical thrombectomy |
| title_sort | predictors of mtici 2c 3 over 2b in patients successfully recanalized with mechanical thrombectomy |
| url | https://doi.org/10.1002/acn3.51935 |
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