title: Correlation of AOL recanalization, TIMI reperfusion and TICI reperfusion with infarct growth and clinical outcome.
abstract: OBJECTIVE
  To understand how three commonly used measures of endovascular therapy correlate with clinical outcome and infarct growth.
  
  
  METHODS
  Prospectively enrolled patients underwent baseline MRI and started endovascular therapy within 12 h of stroke onset. The final angiogram was given a primary arterial occlusive lesion (AOL) recanalization score (0-3), a Thrombolysis in Myocardial Infarction (TIMI) score (0-3) and a Thrombolysis in Cerebral Infarction (TICI) score (0-3). The scores were dichotomized into poor revascularization (AOL 0-2, TIMI 0-1 and TICI 0-2a) versus good revascularization (AOL 3, TIMI 2-3, TICI 2b-3). Patients were classified according to whether or not they had target mismatch (TMM). Good outcome was defined as a 90-day modified Rankin Scale score of 0-2.
  
  
  RESULTS
  Endovascular treatment was attempted in 100. A good outcome was achieved in 57% of patients with a TICI score of 2b-3 and in 24% of patients with a TICI score of 0-2a (p=0.001). Patients with TIMI scores of 2-3 and an AOL score of 3 had lower rates of good outcome (44% and 47%, respectively), which were not significantly better than those with TIMI scores of 0-1 or AOL scores of 0-2. In patients with TMM, these rates of good outcome improved with all the scoring systems and were significantly better for TIMI and TICI scores. Patients with a TICI score of 2a had rates of good functional outcome and lesion growth which were not different from those with TICI scores of 0-1 but were significantly worse than those with TICI scores of 2b-3.
  
  
  CONCLUSIONS
  TIMI 2-3 and TICI 2b-3 reperfusion scores demonstrated improved outcome in patients with tissue mismatch with a small infarct core and a larger hypoperfused region but AOL scores did not. Patients with a TICI score of 2a had a poorer outcome and more lesion growth than those with TICI scores of 2b-3.
authors.affiliation: Departments of Radiology, Stanford University Medical Center, Stanford, California, USA Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Marks
authors.affiliation: Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA Departments of Neurology, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Maarten G
authors.initials: MG
authors.lastname: Lansberg
authors.affiliation: Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA Departments of Neurology, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Mlynash
authors.affiliation: Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA Departments of Neurology, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kemp
authors.affiliation: Departments of Radiology, Stanford University Medical Center, Stanford, California, USA Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: McTaggart
authors.affiliation: Departments of Radiology, Stanford University Medical Center, Stanford, California, USA Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Zaharchuk
authors.affiliation: Departments of Radiology, Stanford University Medical Center, Stanford, California, USA Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Roland
authors.initials: R
authors.lastname: Bammer
authors.affiliation: Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA Stanford Stroke Center, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Albers
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods / Q000592:standards; D057510:Endovascular Procedures / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Angiography; Intervention; MRI; Stroke