The expanded treatment in cerebral infarction (eTICI) score is modified from the modified treatment in cerebral infarction (mTICI) and thrombolysis in cerebral infarction (TICI) scales. It was published by the HERMES investigators in 2019 1.
Using modified Rankin scale (mRs) shift at 90 days as the outcome measure, the investigators found a significant difference in outcomes for patients with partial recanalization after endovascular clot retrieval between those with reperfusion of 50–66%, 67–89% and 90-90% in addition to those previously defined by mTICI.
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Classification
grade 0: no perfusion noted (0% reperfusion)
grade 1: reduction in thrombus but without any resultant filling of distal arterial branches
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grade 2
grade 2a: reperfusion of 1-49% of the territory
grade 2b50: reperfusion of 50–66% of the territory
grade 2b67: reperfusion of 67–89% of the territory
grade 2c: extensive reperfusion of 90–99% of the territory
grade 3: complete or full reperfusion (100% reperfusion)
Important points
inter-rater agreement is the most difficult between eTICI grade 2a and 2b, however with adequate angiographic views agreement of 92% (κ=0.83, p<0.001) was reported by the investigators 1
eTICI appears to be an independent predictor of 90-day mRS
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