2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke? (2024)

LeCouffe, N. E., Kappelhof, M., Treurniet, K. M., Lingsma, H. F., Zhang, G., van den Wijngaard, I. R., van Es, A. C. G. M., Emmer, B. J., Majoie, C. B. L. M., Roos, Y. B. W. E. M., Coutinho, J. M., van Zwam, W., van Oostenbrugge, R. J., & MR CLEAN Registry Investigators (2020). 2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke? Stroke, 51(6), 1790-1796. https://doi.org/10.1161/STROKEAHA.119.028891

LeCouffe, Natalie E. ; Kappelhof, Manon ; Treurniet, Kilian M. et al. / 2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke?. In: Stroke. 2020 ; Vol. 51, No. 6. pp. 1790-1796.

@article{e76befd19366499fb5dbfadb9688ca31,

title = "2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke?",

abstract = "Background and Purpose-A score of >= 2B on the modified Thrombolysis in Cerebral Infarction scale is generally regarded as successful reperfusion after endovascular treatment for ischemic stroke. The extended Thrombolysis in Cerebral Infarction (eTICI) includes a 2C grade, which indicates near-perfect reperfusion. We investigated how well the respective eTICI scores of 2B, 2C, and 3 correlate with clinical outcome after endovascular treatment.Methods-We used data from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry, a prospective, nationwide registry of endovascular treatment in the Netherlands. We included patients with a proximal intracranial occlusion of the anterior circulation for whom final antero-posterior and lateral digital subtraction angiography imaging was available. Our primary outcome was the distribution on the modified Rankin Scale at 90 days per eTICI grade. We performed (ordinal) logistic regression analyses, using eTICI 2B as reference group, and adjusted for potential confounders.Results-In total, 2807/3637 (77%) patients met the inclusion criteria. Of these, 17% achieved reperfusion grade eTICI 0 to 1, 14% eTICI 2A, 25% eTICI 2B, 12% eTICI 2C, and 32% eTICI 3. Groups differed in terms of age (PConclusions-Our results indicate a continuous relationship between reperfusion grade and functional outcome, with eTICI 3 leading to the best outcomes. Although this implies that interventionists should aim for the highest possible reperfusion grade, further research on the optimal strategy is necessary.",

keywords = "cerebral infarction, digital subtraction angiography, goals, reperfusion, thrombectomy, THROMBECTOMY, REVASCULARIZATION, REPERFUSION, RECANALIZATION, METAANALYSIS, OUTCOMES, CARE",

author = "LeCouffe, {Natalie E.} and Manon Kappelhof and Treurniet, {Kilian M.} and Lingsma, {Hester F.} and Guang Zhang and {van den Wijngaard}, {Ido R.} and {van Es}, {Adriaan C. G. M.} and Emmer, {Bart J.} and Majoie, {Charles B. L. M.} and Roos, {Yvo B. W. E. M.} and Coutinho, {Jonathan M.} and {van Zwam}, Wim and {van Oostenbrugge}, {Robert Jan} and {MR CLEAN Registry Investigators}",

note = "Publisher Copyright: {\textcopyright} 2020 Lippincott Williams and Wilkins. All rights reserved.",

year = "2020",

month = jun,

doi = "10.1161/STROKEAHA.119.028891",

language = "English",

volume = "51",

pages = "1790--1796",

journal = "Stroke",

issn = "0039-2499",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "6",

}

LeCouffe, NE, Kappelhof, M, Treurniet, KM, Lingsma, HF, Zhang, G, van den Wijngaard, IR, van Es, ACGM, Emmer, BJ, Majoie, CBLM, Roos, YBWEM, Coutinho, JM, van Zwam, W, van Oostenbrugge, RJ & MR CLEAN Registry Investigators 2020, '2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke?', Stroke, vol. 51, no. 6, pp. 1790-1796. https://doi.org/10.1161/STROKEAHA.119.028891

2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke? / LeCouffe, Natalie E.; Kappelhof, Manon; Treurniet, Kilian M. et al.
In: Stroke, Vol. 51, No. 6, 06.2020, p. 1790-1796.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - 2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke?

AU - LeCouffe, Natalie E.

AU - Kappelhof, Manon

AU - Treurniet, Kilian M.

AU - Lingsma, Hester F.

AU - Zhang, Guang

AU - van den Wijngaard, Ido R.

AU - van Es, Adriaan C. G. M.

AU - Emmer, Bart J.

AU - Majoie, Charles B. L. M.

AU - Roos, Yvo B. W. E. M.

AU - Coutinho, Jonathan M.

AU - van Zwam, Wim

AU - van Oostenbrugge, Robert Jan

AU - MR CLEAN Registry Investigators

N1 - Publisher Copyright:© 2020 Lippincott Williams and Wilkins. All rights reserved.

PY - 2020/6

Y1 - 2020/6

N2 - Background and Purpose-A score of >= 2B on the modified Thrombolysis in Cerebral Infarction scale is generally regarded as successful reperfusion after endovascular treatment for ischemic stroke. The extended Thrombolysis in Cerebral Infarction (eTICI) includes a 2C grade, which indicates near-perfect reperfusion. We investigated how well the respective eTICI scores of 2B, 2C, and 3 correlate with clinical outcome after endovascular treatment.Methods-We used data from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry, a prospective, nationwide registry of endovascular treatment in the Netherlands. We included patients with a proximal intracranial occlusion of the anterior circulation for whom final antero-posterior and lateral digital subtraction angiography imaging was available. Our primary outcome was the distribution on the modified Rankin Scale at 90 days per eTICI grade. We performed (ordinal) logistic regression analyses, using eTICI 2B as reference group, and adjusted for potential confounders.Results-In total, 2807/3637 (77%) patients met the inclusion criteria. Of these, 17% achieved reperfusion grade eTICI 0 to 1, 14% eTICI 2A, 25% eTICI 2B, 12% eTICI 2C, and 32% eTICI 3. Groups differed in terms of age (PConclusions-Our results indicate a continuous relationship between reperfusion grade and functional outcome, with eTICI 3 leading to the best outcomes. Although this implies that interventionists should aim for the highest possible reperfusion grade, further research on the optimal strategy is necessary.

AB - Background and Purpose-A score of >= 2B on the modified Thrombolysis in Cerebral Infarction scale is generally regarded as successful reperfusion after endovascular treatment for ischemic stroke. The extended Thrombolysis in Cerebral Infarction (eTICI) includes a 2C grade, which indicates near-perfect reperfusion. We investigated how well the respective eTICI scores of 2B, 2C, and 3 correlate with clinical outcome after endovascular treatment.Methods-We used data from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry, a prospective, nationwide registry of endovascular treatment in the Netherlands. We included patients with a proximal intracranial occlusion of the anterior circulation for whom final antero-posterior and lateral digital subtraction angiography imaging was available. Our primary outcome was the distribution on the modified Rankin Scale at 90 days per eTICI grade. We performed (ordinal) logistic regression analyses, using eTICI 2B as reference group, and adjusted for potential confounders.Results-In total, 2807/3637 (77%) patients met the inclusion criteria. Of these, 17% achieved reperfusion grade eTICI 0 to 1, 14% eTICI 2A, 25% eTICI 2B, 12% eTICI 2C, and 32% eTICI 3. Groups differed in terms of age (PConclusions-Our results indicate a continuous relationship between reperfusion grade and functional outcome, with eTICI 3 leading to the best outcomes. Although this implies that interventionists should aim for the highest possible reperfusion grade, further research on the optimal strategy is necessary.

KW - cerebral infarction

KW - digital subtraction angiography

KW - goals

KW - reperfusion

KW - thrombectomy

KW - THROMBECTOMY

KW - REVASCULARIZATION

KW - REPERFUSION

KW - RECANALIZATION

KW - METAANALYSIS

KW - OUTCOMES

KW - CARE

U2 - 10.1161/STROKEAHA.119.028891

DO - 10.1161/STROKEAHA.119.028891

M3 - Article

C2 - 32397926

SN - 0039-2499

VL - 51

SP - 1790

EP - 1796

JO - Stroke

JF - Stroke

IS - 6

ER -

LeCouffe NE, Kappelhof M, Treurniet KM, Lingsma HF, Zhang G, van den Wijngaard IR et al. 2B, 2C, or 3 What Should Be the Angiographic Target for Endovascular Treatment in Ischemic Stroke? Stroke. 2020 Jun;51(6):1790-1796. doi: 10.1161/STROKEAHA.119.028891