Modified treatment in cerebral infarction (mTICI) score

Last revised by Calum Worsley on 22 Mar 2024

The modified treatment in cerebral infarction (mTICI) score was developed from the original thrombolysis in cerebral infarction (TICI) scale by a consensus group in 2013 1. The recommendations included a name change to better reflect the increasing use of endovascular clot retrieval for ischemic stroke, and simplification of the TICI 2 component to less than half of the target vascular territory (mTICI 2a) or more than half (mTICI 2b). Since its initial description, mTICI 2c has also been added to the score 5.

Classification

  • grade 0: no perfusion

  • grade 1: antegrade reperfusion past the initial occlusion, but limited distal branch filling with little or slow distal reperfusion

  • grade 2

    • grade 2a: antegrade reperfusion of less than half of the occluded target artery previously ischemic territory (e.g. in one major division of the middle cerebral artery (MCA) and its territory)

    • grade 2b: antegrade reperfusion of more than half of the previously occluded target artery ischemic territory (e.g. in two major divisions of the MCA and their territories)

    • grade 2c: near complete perfusion except for slow flow or distal emboli in a few distal cortical vessels

      • this was not part of the original mTICI score, but was added later and has since become widely accepted as being part of the scoring 4

  • grade 3: complete antegrade reperfusion of the previously occluded target artery ischemic territory, with absence of visualized occlusion in all distal branches

See also

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