Background and Purpose

Modified Thrombolysis in Cerebral Infarction (mTICI)2b/3 has been considered the criterion for successful reperfusion in endovascular treatment. This study aimed to compare the therapeutic safety and efficacy of mTICI2b and mTICI3 recanalization, and to analyze the factors related to outcomes in everyday clinical practice.

Materials and Methods

This is a single-center retrospective analysis of 224 patients who underwent successful thrombectomy (achieving a mTICI score ≥2b). The primary outcomes included a modified Rankin score (mRS) of 0-2 at 90-day, mortality, and symptomatic intracranial hemorrhage.

Results

A total of 111 patients achieved mTICI2b status (49.6%), and 113 achieved mTICI3 status (50.4%). The comparison between mTICI2b and 3 reperfusions showed no differences in short-term outcomes, 90-day mRS, complications, and mortality. There was a trend toward more passes in mTICI2b patients, although the difference was not significant. The univariate analysis showed that poor outcomes after endovascular treatment were associated with older age, previous history of coronary heart disease, atrial fibrillation, diabetes, tandem occlusions, high National Institutes of Health Stroke Scale (NIHSS) score on admission, and general anesthesia. A previous history of coronary heart disease, a high NIHSS score on admission, and the use of general anesthesia were independent factors that affected the therapeutic effects.

Conclusion

The superiority (efficacy and safety) of mTICI3 reperfusion was not significant compared with that of mTICI2b reperfusion. Prolonged efforts to achieve mTICI3 after achieving mTICI2b should be considered prudently for those with difficulty achieving 100% reperfusion.

中文翻译：

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mTICI2b和3再通的血管内治疗对急性前循环卒中患者的治疗作用

背景和目的

改良型脑梗死溶栓（mTICI）2b / 3被认为是血管内治疗成功再灌注的标准。这项研究旨在比较mTICI2b和mTICI3再通的治疗安全性和疗效，并分析日常临床实践中与预后相关的因素。

材料和方法

这是对224例成功完成血栓切除术（mTICI评分≥2b）的患者进行的单中心回顾性分析。主要结局包括90天时兰金评分（mRS）修改为0-2，死亡率和有症状的颅内出血。

结果

共有111例患者达到mTICI2b状态（49.6％），113例达到mTICI3状态（50.4％）。mTICI2b与3次再灌注之间的比较显示，短期结果，90天mRS，并发症和死亡率无差异。尽管差异并不显着，但mTICI2b患者中有更多通过的趋势。单因素分析表明，血管内治疗后不良结局与年龄，先前的冠心病史，房颤，糖尿病，串联阻塞，入院时美国国立卫生研究院卒中量表（NIHSS）评分高以及全身麻醉有关。冠心病的既往史，入院时NIHSS得分高以及使用全身麻醉是影响治疗效果的独立因素。

结论

与mTICI2b再灌注相比，mTICI3再灌注的优越性（有效性和安全性）并不显着。对于那些难以实现100％再灌注的患者，应谨慎考虑在达到mTICI2b后为达到mTICI3所做的长期努力。