Modified treatment in cerebral ischemia (mTICI) score
Citation, DOI & article data
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.
- 1. Zaidat OO, Yoo AJ, Khatri P et-al. Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement. Stroke. 2013;44 (9): 2650-63. doi:10.1161/STROKEAHA.113.001972 - Free text at pubmed - Pubmed citation
- 2. Gerber JC, Miaux YJ, von Kummer R. Scoring flow restoration in cerebral angiograms after endovascular revascularization in acute ischemic stroke patients. Neuroradiology. 2015;57 (3): 227-40. doi:10.1007/s00234-014-1460-x - Pubmed citation
- 3. Almekhlafi M, Mishra S, Desai J et-al. Interventional Neuroradiology. 2014;20 (1): . doi:10.15274/INR-2014-10004