Document Detail


Revascularization grading in endovascular acute ischemic stroke therapy.
MedLine Citation:
PMID:  23008384     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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
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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    
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain Ischemia / pathology*,  therapy
Cerebral Revascularization / methods*
Endovascular Procedures / methods*
Humans
Severity of Illness Index*
Stroke / pathology*,  therapy
Thrombolytic Therapy / methods
Grant Support
ID/Acronym/Agency:
K24 NS072272/NS/NINDS NIH HHS
Comments/Corrections

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