Abstract 163: TICI Success Rates In Swift: Comparison Between Randomized Arms And Correlation To 90 Day Neurologic Outcome
Background and Purpose — TICI scores are used to assess recanalization in clinical settings. We evaluated TICI outcomes in the SWIFT randomized controlled trial of mechanical thrombectomy in ischemic stroke along with their association with outcomes.
Methods — One hundred and thirty four subject angiograms were analyzed and TICI scores assessed by an independent core laboratory. Successful recanalization was defined as either TICI 2a, 2b or 3, TICI 2b or 3 or alternatively as TICI 3 alone. These success definitions were compared between subject groups in the study after use of randomized device and post rescue therapy. For the entire study population of 134 subjects, TICI success was associated with 90-day functionally independent outcome, defined as modified Rankin Score (mRS) zero to 2.
Results — Table 1 shows TICI success rates after use of randomized device and post rescue therapy. Post randomized device use, significantly greater rates of TICI 2b-3 and TICI 3 success were observed in the Solitaire FR group than in the MERCI group. Under the alternative definition of success as TICI 2a-3, a trend toward significance persisted post randomized device use. Post rescue therapy, significantly greater TICI 3 rates were observed and a trend toward significance was seen in favor of Solitaire FR in TICI 2b-3 success. Among all subjects including roll-ins (who were treated with Solitaire FR), functionally independent outcome was strongly associated with successful recanalization using the 2b-3 definition (48.7% vs. 17.4%, p=0.0005), the 2a-3 definition (44.9% vs. 15.2%, p=0.0028) and TICI 3 alone (52.1% vs. 20.7%, p=0.0071).
Conclusions — TICI scores after mechanical thrombectomy device use were better among subjects randomized to Solitaire FR than in those randomized to MERCI. Good clinical outcome defined using mRS at 90 days was strongly associated with successful recanalization using three different TICI success definitions.
- © 2012 by American Heart Association, Inc.