Study | Study type | Multicentre | TICI | n | TICI grading provided by | Definition of mortality provided | Differences in baseline characteristics | Definition of sICH | Sites of occlusion included | Adjusted analysis available | Adjusted for | ||
TICI3 | TICI2b | TICI2c | |||||||||||
Dargazanli et al 7 | RO | Yes | mTICI | 113 | 109 | – | One neuroradiologist, blinded to the interventionalists’ gradings and clinical outcomes | 3-month mortality | Better collaterals, less cardioembolic aetiology, shorter onset to reperfusion metrics, lower number of passes in TICI3 patients | Presence of ICH with NIHSS worsening of ≥4 within 24 hours or prompting death | ICA, M1, M2 | Yes | Centre, age, diabetes, admission NIHSS score, prior use of intravenous thrombolysis, site of occlusion, favourable collateral flow, aetiology and onset to reperfusion time |
Almekhlafi et al 17 | RO | No | mTICI and eTICI | 29 | 27 | 32 | Two neurointerventionalists (blinding not specified, one graded eTICI, one graded mTICI) | 3-month mortality | No P values available, however, faster imaging to reperfusion times and higher number treated with intravenous tPA in TICI2c/3 patients | SITS-MOST | Anterior circulation stroke, not further specified | No | NA |
Yoo et al 3 | RO | Yes | mTICI | 53 | 97 | – | Consensus reading of neurointerventionalists and stroke neurologists with significant clinical and research experience in intra-arterial treatment | NA | NA | NA | M1 | No | NA |
Carvalho et al 25 | RO | No | mTICI | 110 | 68 | – | Operator measured, non-blinded | 3-month mortality | Not statistically significant shorter onset to reperfusion metrics in TICI3 patients | ECASS | ICA, M1, M2, tandem | Yes | Age, sex, diabetes, hypertension, left hemispheric stroke, symptom to reperfusion time |
Kaesmacher et al16 | RO | No | eTICI | 45 | 117 | 84 | Two neuroradiologists in consensus, blinded to interventionalist’s grading and clinical outcomes | In-hospital mortality | Not statistically significant shorter onset to reperfusion metrics in TICI2c/3 patients | PH1/2 (radiological) | M1/M2 | Yes | Age, admission NIHSS, onset to reperfusion time, pretreatment alteplase |
Chamorro et al 23 | RO | No | mTICI | 74 | 51 | – | Experienced radiologists and interventionalists (number not specified), blinded to all clinical data | 3-month mortality | Shorter onset to reperfusion metrics, lower number of passes and better collaterals in TICI3 patients | Presence of ICH and NIHSS worsening of ≥4 | ICA, M1, M2, tandem | Yes | Age, sex, admission NIHSS, target occlusion location, ASPECTS, pretreatment alteplase and collaterals |
Linfante et al 26 | RO | Yes | mTICI | 127 | 107 | – | Site-specific grading, not further specified | NA | NA | NA | M1, M2, ICA, basilar (10%) | No | |
Rangaraju et al 27 | RO | No | mTICI | 35 | 64 | – | Operator measured, non-blinded | 3-month mortality | None | ICA, M1 | Yes | Age, NIHSS and ASPECTS | |
Schmitz et al 24 | PH-RCT | Yes | mTICI | 6 | 94 | – | Core lab adjudicated (IMS III) | NA | NA | NA | ICA, M1, M2 | No | NA |
Humphries et al 28* | RO | Yes | Not specified | 52 | 37 | – | Operator measured, non-blinded | NA | NA | NA | M1, M2, ICA, basilar (10%) | No | NA |
Massari et al 29 | RO | No | mTICI | 23 | 18 | – | Operator measured, non-blinded | NA | NA | NA | M1, M2, ICA, basilar/vertebrobasilar junction (~10%) | No | NA |
Marks et al 30 | PH-RCT | Yes | mTICI | 18 | 28 | – | Core lab adjudicated (DEFUSE 2) | NA | NA | NA | M1, M2, M3, ICA | No | NA |
Goyal et al 31 | RO | Yes | Not specified | 200 | 216 | – | Not specified | 3-month mortality | None | Not specified | NA | Yes | Not specified (‘potential confounders’) |
Liebeskind et al 13 | PH-RCT | Yes | oTICI2C | 44 | 258 | 125 | Core lab adjudicated (HERMES) | 3-month mortality | NA | NA | ICA, M1 | No | NA |
*There are discrepancies regarding the true rate of TICI3 and TICI2b reperfusions. While table 3 of the respective publication suggests that there are 52 TICI3 cases and 37 TICI2b cases, the text states that there were 46 TICI3 cases. The numbers used for quantitative analysis are derived from table 3 of this publication.
ASPECTS, Alberta Stroke Program Early CT Score; DEFUSE 2, Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution Study 2; ECASS, European Cooperative Acute Stroke Study; eTICI, extended TICI scale; HERMES, Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials; ICA, internal carotid artery; ICH, intracranial haemorrhage; IMS III, Interventional Management of Stroke III; M1/M2/M3, segment one/two/three of the middle cerebral artery; mTICI, modified TICI scale; NA, not applicable; NIHSS, National Institutes of Health Stroke Scale; oTICI, original TICI scale; PH, parenchymal haematoma; PH-RCT, post hoc analysis of randomised controlled trial data; RO, retrospective observational; sICH, symptomatic intracranial haemorrhage; SITS-MOST, Safe Implementation of Thrombolysis in Stroke- Monitoring Study; TICI, thrombolysis in cerebral infarction; tPA, tissue plasminogen activator. Total number of patients n= 2461, n=2379 with available follow-up for the primary outcome (mRS at day 90).