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Benchmarking the Ex...
Benchmarking the Extent and Speed of Reperfusion: First Pass TICI 2c-3 Is a Preferred Endovascular Reperfusion Endpoint
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Yoo, AJ (författare)
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Soomro, J (författare)
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- Andersson, T (författare)
- Karolinska Institutet
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Saver, JL (författare)
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Ribo, M (författare)
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Bozorgchami, H (författare)
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Dabus, G (författare)
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Liebeskind, DS (författare)
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Jadhav, A (författare)
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Mattle, H (författare)
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Zaidat, OO (författare)
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(creator_code:org_t)
- 2021-05-11
- 2021
- Engelska.
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Ingår i: Frontiers in neurology. - : Frontiers Media SA. - 1664-2295. ; 12, s. 669934-
- Relaterad länk:
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https://www.frontier...
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http://kipublication...
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https://doi.org/10.3...
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Abstract
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- 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.Clinical Trial Registration:http://www.clinicaltrials.gov, identifier NCT02488915.
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Yoo, AJ
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Soomro, J
-
Andersson, T
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Saver, JL
-
Ribo, M
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Bozorgchami, H
-
visa fler...
-
Dabus, G
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Liebeskind, DS
-
Jadhav, A
-
Mattle, H
-
Zaidat, OO
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visa färre...
- Artiklar i publikationen
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Frontiers in neu ...
- Av lärosätet
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Karolinska Institutet