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22. European Stroke Conference 15 Interventional neurology A 15:20 - 15:30 Not All Successful Reperfusion Patients Are Equal: The Need for a TICI2c Score M.A. Almekhlafi1, M. EESA2, J. Desai3, S. Mishra4, V. Nambiar5, O. Volny6, B.K. Menon7, A.M. Demchuk8, M. Goyal9 University of Calgary - King Abdulaziz Unviersity, Calgary, CANADA1,Unviersity of Cal-gary, Calgary, CANADA2, Unviersity of Calgary, Calgary, CANADA3, Unviersity of Calgary, Calgary, CANADA4, Unviersity of Calgary, Calgary, CANADA5, Unviersity of Calgary, Cal-gary, 6, Unviersity of Calgary, Calgary, 7, Unviersity of Calgary- HBI, Calgary, 8, University of Calgary - HBI, Calgary, CANADA9 OBJECTIVE Many recent endovascular studies have used the TICI grading system for evalu-ating angiographic outcomes and have used TICI 2B and 3 for successful recanalization as long as the final perfusion defect was < 50% of the MCA territory. We propose a new scoring system that separates successful but incomplete reperfusion into 2 categories taking into account the size of the reperfusion defect. METHODS This is a longitudinal cohort including of anterior circulation stroke patients treated using intra-arterial stentrievers in our center between Jan 2011 to Dec 2012. Failed reperfusion was defined as per the standard TICI score (TICI 0-2a). Successful reperfusion was defined as 2b: substantial perfusion with distal branch filling of ≥ 50% of territory visualized, 2c: near complete perfusion except for slow flow in a few distal cortical vessels, or presence of small distal cortical emboli, 3: complete perfusion with nor-mal filling of all distal branches. Angiograms were scored by a single reviewer blinded of the patients’ outcomes. RESULTS In a cohort of 101 patients, 78 achieved successful reperfusion (77.2%). The results of patients with successful reperfusion is presented according to the reper-fusion score (Table). The proportion of patients who had significant improvement of their clini-cal deficits in 24 hours (24-hour NIHSS score drop by 75%) was significantly higher with TIC-I2c reperfusion than those with TICI2b (50% vs. 24%, Fisher’s exact p 0.04). CONCLUSIONS Categorizing successful but incomplete reperfusion into 2 different classes according to the area of perfusion defect has merits. In this cohort, there was evidence toward different short-term clinical and imaging outcomes in patients with TICI2b vs. TICI2c scores. These findings need to be validated in larger cohorts. 67 years old female patient with acute ischemic stroke with left sided hemiplegia occurred during hospitalization at our tertiary institution due to new-onset atrial fibrillation. Digital sub-traction angiography (DSA) performed 60 minutes after symptom onset confirmed right ACM (M1) occlusion with embolus originated from the heart (A). Complete recanalization (TICI 3) was achieved after one pass of stent-retriever device (B). Needle to recanalization time was 35 minutes. Patient was discharged from the hospital with complete neurological recovery 152 © 2013 S. Karger AG, Basel Scientific Programme


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