Document Detail

Revascularization grading in endovascular acute ischemic stroke therapy.
MedLine Citation:
PMID:  23008384     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recanalization and angiographic reperfusion are key elements to successful endovascular and interventional acute ischemic stroke (AIS) therapy. Intravenous recombinant tissue plasminogen activator (rt-PA), the only established revascularization therapy approved by the US Food & Drug Administration for AIS, may be less effective for large artery occlusion. Thus, there is enthusiasm for endovascular revascularization therapies, which likely provide higher recanalization rates, and trials are ongoing to determine clinical efficacy and compare various methods. It is anticipated that clinical efficacy will be well correlated with revascularization of viable tissue in a timely manner.
METHOD: Reporting, interpretation, and comparison of the various revascularization grading methods require agreement on measurement criteria, reproducibility, ease of use, and correlation with clinical outcome. These parameters were reviewed by performing a Medline literature search from 1965 to 2011. This review critically evaluates current revascularization grading systems.
RESULTS AND CONCLUSION: The most commonly used revascularization grading methods in AIS interventional therapy trials are the thrombolysis in cerebral ischemia (TICI, pronounced "tissy") and thrombolysis in myocardial ischemia (TIMI) scores. Until further technical and imaging advances can incorporate real-time reliable perfusion studies in the angio-suite to delineate regional perfusion more accurately, the TICI grading system is the best defined and most widely used scheme. Other grading systems may be used for research and correlation purposes. A new scale that combines primary site occlusion, lesion location, and perfusion should be explored in the future.
O O Zaidat; M A Lazzaro; D S Liebeskind; N Janjua; L Wechsler; R G Nogueira; R C Edgell; J S Kalia; A Badruddin; J English; D Yavagal; J F Kirmani; A V Alexandrov; P Khatri
Related Documents :
25387824 - Left ventricular mass and progenitor cells in chronic heart failure patients.
3548644 - Coronary vasculitis. a review in the current scheme of classification of vasculitis.
25347774 - Acute, delayed and chronic remote ischemic conditioning is associated with downregulati...
25129394 - Assessment of left ventricular volumes with echocardiography and cardiac magnetic reson...
19715884 - Low troponin-i levels on admission are associated with worse prognosis in patients with...
9236434 - Effects of rheothrx on mortality, morbidity, left ventricular function, and infarct siz...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurology     Volume:  79     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-25     Completed Date:  2012-12-14     Revised Date:  2014-08-19    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S110-6     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Brain Ischemia / pathology*,  therapy
Cerebral Revascularization / methods*
Endovascular Procedures / methods*
Severity of Illness Index*
Stroke / pathology*,  therapy
Thrombolytic Therapy / methods
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  How well do blood flow imaging and collaterals on angiography predict brain at risk?
Next Document:  Advances in thrombolytics for treatment of acute ischemic stroke.