Outcomes in patients with " successful" recanalization in anterior circulation stroke treated with mechanical thrombectomy: TICI 3 versus TICI 2b

Abstract

Objective To investigate the difference in the outcomes in patients with acute anterior circulation stroke having achieved the Thrombolysis in Cerebral Infarction (TICI) 2b and TICI 3 recanalization after mechanical thrombectomy. Methods The patients with acute anterior circulation stroke having achieved successful recanalization after mechanical thrombectomy were enrolled retrospectively. They were divided into TICI 2b ( almost complete recanalization) group and TICI 3 ( complete recanalization) group. The good outcome was defined as the modified Rankin Scale score 0-2 at 3 months after onset. Results A total of 83 patients were enrolled in the study, including 38 patients (45.8%) with TICI 2b and 45 (54.2%) with TICI 3; 49 (59.0%) had good outcome, and 34 (40.9%) had poor outcome. The good outcome rate in the TICI 3 group was significantly higher than that in the TICI 2b group (68.9% vs. 47.4%; χ2=3.946, P=0.047). After adjusting for age, hypertension, diabetes, baseline systolic blood pressure, triglyceride, intravenous thrombolysis, and ASITN/SIR collateral grades, TICI 3 was an independent predictor for good outcome at 3 months after onset (odds ratio [OR] 3.759, 95% confidence interval [CI] 1.098-12.871; P=0.035), while the higher baseline National Institutes of Health Stroke Scale score (OR 0.820, 95% CI 0.715-0.941; P=0.005) and higher fasting glucose (OR 0.610, 95% CI 0.410-0.906; P=0.014) were the independent predictors for poor outcome at 3 months after onset. Conclusions There are difference in the outcomes in patients with successful recanalization in anterior circulation stroke treated with mechanical thrombectomy. The outcome is substantially better in TICI 3 than TICI 2b patients. Key words: Stroke; Brain Ischemia; Thrombectomy; Endovascular Procedures; Treatment Outcome