Modified treatment in cerebral ischemia (mTICI) score

Last revised by Tim Luijkx on 01 May 2018

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 therapy for 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).


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

A review of scoring systems for flow restoration after endovascular revascularization 2 observed that some authors had proposed a further modification with the introduction of a "grade 2c" 3 ("near complete perfusion except for slow flow or distal emboli in a few distal cortical vessels"), but that this had not yet reached consensus approval. 

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