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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1486586

Can Ischemic Stroke Patients with mTICI of 2b Achieve Similar Outcomes Compared to Those with Complete Recanalization Following Endovascular Therapy?

Provisionally accepted
Zunbao Xu Zunbao Xu 1Sahibjot Grewal Sahibjot Grewal 2*Mohammad Mofatteh Mohammad Mofatteh 3Adam A. Dmytriw Adam A. Dmytriw 4Dongqing Zhao Dongqing Zhao 1*Baikeng Chen Baikeng Chen 1*Haoyang Chen Haoyang Chen 1*Wanyi He Wanyi He 1*Rixin Luo Rixin Luo 1*Zhenzhang Li Zhenzhang Li 5*Qiaowei Li Qiaowei Li 1*
  • 1 Guangzhou Panyu Central Hospital, Guangzhou, China
  • 2 University of Toronto, Toronto, Ontario, Canada
  • 3 Queen's University Belfast, Belfast, United Kingdom
  • 4 Harvard Medical School, Boston, Massachusetts, United States
  • 5 Guangdong Polytechnic Normal University, Guangzhou, Guangdong, China

The final, formatted version of the article will be published soon.

    Background and purpose: Endovascular therapy (EVT) has been used as a standard treatment method for patients with large vessel ischemic stroke within 24 hours of the onset. The extent of recanalization after EVT can be assessed using the modified thrombolysis in cerebral infarction (mTICI) scale as an accepted angiographic grading system. In this study, we aimed to investigate whether patients with a mTICI grade of 2b achieve similar outcomes compared to those with complete recanalization (mTICI of 3) following EVT for acute ischemic stroke. Methods: A retrospective analysis was conducted on 196 consecutive patients who underwent EVT in a comprehensive stroke center. In the final study, 176 patients were included based on the inclusion criteria. The primary outcome was the 3-month modified Rankin Scale (mRS) of 0-2 considered as a favorable outcome, while excellent outcomes were defined as mRS scores of 0-1. Results: Our data showed that 59.46% of patients in the mTICI 2b group achieved a favorable outcome, comparable to 58.99% observed in the mTICI 3 group (p=0.959). Additionally, 54.05% (n=37) of patients with mTICI 2b achieved an excellent outcome, compared to 51.80% (n=139) in the mTICI 3 group (p=0.807). The case fatality rates were also comparable between the groups, with 8.11% in the mTICI 2b group and 10.79% in the mTICI 3 group (p=0.632). Overall, there were no statistically significant differences between the two groups in terms of 3-month favorable outcomes, excellent outcomes, or mortality. Conclusion: Similar 3-month outcomes can be achieved for ischemic stroke patients undergoing EVT with a mTICI grade of 2b compared to those with a mTICI grade of 3. These data can help clinicians in setting realistic expectations and making informed decisions during EVT procedures.

    Keywords: Endovascular Therapy, Acute ischemic stroke, mTICI, patient outcome, Large vessel stroke

    Received: 26 Aug 2024; Accepted: 18 Oct 2024.

    Copyright: © 2024 Xu, Grewal, Mofatteh, Dmytriw, Zhao, Chen, Chen, He, Luo, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sahibjot Grewal, University of Toronto, Toronto, M5S 1A1, Ontario, Canada
    Dongqing Zhao, Guangzhou Panyu Central Hospital, Guangzhou, China
    Baikeng Chen, Guangzhou Panyu Central Hospital, Guangzhou, China
    Haoyang Chen, Guangzhou Panyu Central Hospital, Guangzhou, China
    Wanyi He, Guangzhou Panyu Central Hospital, Guangzhou, China
    Rixin Luo, Guangzhou Panyu Central Hospital, Guangzhou, China
    Zhenzhang Li, Guangdong Polytechnic Normal University, Guangzhou, Guangdong, China
    Qiaowei Li, Guangzhou Panyu Central Hospital, Guangzhou, China

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