ABSTRACT
Background and Purpose
The superiority of achieving modified Treatment in Cerebral Ischemia (mTICI) from multiple passes versus mTICI 2b from a single pass remains uncertain. We aimed to assess whether additional passes in M1 occlusion patients with a first-pass mTICI 2b score improved clinical and functional outcomes.
Methods
We analyzed Registry Combined vs. Single Thrombectomy Techniques registry data of consecutive M1-occlusion patients, comparing outcomes of those with mTICI 2b-stopped after the first pass versus continued mechanical thrombectomy (MT) to improve angiographic results (mTICI 2b or mTICI 2c/3). We compared demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale [NIHSS] at 24 h and modified Rankin Scale at 3 months).
Results
Patients with first-pass mTICI 2b had lower NIHSS scores at admission, fewer left-side occlusions, and longer last-seen-well times. Endovascular techniques and time from groin puncture to revascularization were similar across groups. Patients with final mTICI 2c/3 had the highest distal embolism rates in a new territory (0% for mTICI2b-stopped vs. 3% for final mTICI2b-continued; 7.7% for final mTICI2c/3; p = 0.02). The groups had similar rates of death, symptomatic intracranial hemorrhage, same-area distal embolism, other MT-related complications, NIHSS at 24 h, NIHSS change from admission to 24 h, and same-territory distal embolism.
Conclusion
Achieving mTICI 2b after the first pass in M1-occlusion patients proved relevant. These patients had comparable clinical and functional outcomes and a lower risk of new territory distal embolisms compared to those with final mTICI 2c/3 scores.
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This post is Copyright: Juan Ignacio García‐García,
Josep Puig,
Óscar Chirife,
Andrés Paipa,
Sònia Aixut,
Jordi Blasco,
Mariano Werner,
Marc Comas‐Cufí,
Pedro Vega,
Eduardo Murias,
Fernando Aparici‐Robles,
Lluís Morales‐Caba,
Eva González,
Ion Labayen,
Veredas Romero,
Isabel Bravo,
Manuel Moreu,
Alfonso López‐Frías,
Sebastià Remollo,
Isabel Rodríguez‐Caamaño,
Mikel Terceño,
Juan Álvarez‐Cienfuegos,
Javier Martínez‐Fernández,
Yeray Aguilar,
José Carlos Méndez,
Fernando Sánchez,
Joaquín Zamarro,
Víctor Cuba,
Miguel Castaño,
Antonio López‐Rueda,
ROSSETTI Group | April 26, 2025
Wiley: Journal of Neuroimaging: Table of Contents