title: The Capillary Index Score before thrombectomy: an angiographic correlate of favorable outcome.
abstract: OBJECTIVE
  The angiography based Capillary Index Score (CIS) has recently emerged as a potential surrogate marker of cerebral perfusion before intra-arterial thrombolysis. We assessed the prevalence of a favorable CIS (f-CIS) and its relationship with clinical outcome in patients treated by mechanical thrombectomy (MT).
  
  
  METHODS
  Data from consecutive patients treated by MT from acute middle cerebral artery (MCA) occlusion were retrospectively analyzed. CIS was calculated from a pre-intervention cerebral angiogram. Association with favorable clinical outcome (modified Rankin Scale score ≤2) at 3 months was assessed in multivariate analysis.
  
  
  RESULTS
  146 patients were included in the study. f-CIS was observed in 106/146 (72%) patients with an acceptable inter-rater agreement (κ=0.73, p<0.001). It was associated with a lower pretreatment National Institutes of Health Stroke Scale (NIHSS) score (p=0.014), an isolated M1/M2 occlusion without internal carotid occlusion (p=0.042), and an Alberta Stroke Program Early CT Score (ASPECTS) >4 (p=0.004). In binary regression, a favorable outcome was independently associated with f-CIS (OR (-95% CI, +95% CI)=3.8 (1.3 to 10.9), p=0.013), as well as NIHSS (p=0.007), ASPECTS (p=0.005), isolated M1/M2 occlusion (p=0.013), and age (p=0.032). The positive predictive value of f-CIS for a favorable outcome was 67%.
  
  
  CONCLUSIONS
  f-CIS was strongly associated with a favorable outcome after MT of acute MCA occlusion. As an easy surrogate marker of cerebral perfusion, it may be a useful-albeit not sufficient-diagnostic test to select patients just before an MT or to manage them after recanalization.
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Paul-Emile
authors.identifier: http://orcid.org/0000-0002-2536-6338
authors.initials: PE
authors.lastname: Labeyrie
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Hocine
authors.initials: H
authors.lastname: Redjem
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Blanc
authors.affiliation: Department of Neuroradiology, Hôpital Lariboisière, Paris, France.
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Labeyrie
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Bartolini
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ciccio
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Robert
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Boaz
authors.initials: B
authors.lastname: Gilboa
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Fahed
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Abrivard
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Piotin
mesh_terms: D000368:Aged; D002196:Capillaries / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods / Q000639:trends*; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D017131:Thrombectomy / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome
keywords: Angiography; Stroke; Thrombectomy