Firas Al-Ali1, Thomas A Tomsick2, John J Connors2, James M Gebel2, John J Elias2, Georges Z Markarian2, Zein Al-Ali2, Joseph P Broderick2. 1. From the Division of Neurointerventional Surgery, CNS Healthcare Foundation, Akron, OH (F.A.-A., G.Z.M., Z.A.-A.); Department of Radiology (T.A.T.) and Department of Neurology and Rehabilitation Medicine (J.P.B.), University of Cincinnati Neuroscience Institute, OH; Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (J.J.C.); and Department of Neurology (J.M.G.) and Department of Research (J.J.E.), Akron General Medical Center, OH. firasalali@aol.com. 2. From the Division of Neurointerventional Surgery, CNS Healthcare Foundation, Akron, OH (F.A.-A., G.Z.M., Z.A.-A.); Department of Radiology (T.A.T.) and Department of Neurology and Rehabilitation Medicine (J.P.B.), University of Cincinnati Neuroscience Institute, OH; Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (J.J.C.); and Department of Neurology (J.M.G.) and Department of Research (J.J.E.), Akron General Medical Center, OH.
Abstract
BACKGROUND AND PURPOSE: The Capillary Index Score (CIS) is a simple angiography-based scale for assessing viable tissue in the ischemic territory. We retrospectively applied it to Interventional Management of Stroke (IMS) trials I and II to evaluate the predictive value for good outcomes. METHODS: CIS was calculated from pretreatment diagnostic cerebral angiograms blinded to outcome. IMS I and II diagnostic cerebral angiogram images of sufficient quality were reviewed and CIS calculated for treated subjects with internal carotid artery or M1 occlusion. CIS scoring (0-3) was dichotomized into favorable (f CIS; 2 or 3) and poor (p CIS; 0 or 1). Modified thrombolysis in cerebral infarction score 2b or 3 was considered good revascularization. CIS and modified thrombolysis in cerebral infarction scores were compared with good outcome, defined as modified Rankin Scale score≤2 at 90 days. RESULTS: Twenty-eight of 161 subjects met the inclusion criteria. Thirteen (46%) had f CIS. Good clinical outcome was significantly different between the 2 CIS groups (62% for f CIS versus 7% for p CIS; P=0.004). Good reperfusion correlated to good outcome (P=0.04). No significant differences in time to intravenous or intra-arterial treatment were identified between f CIS and p CIS groups (P>0.25). CONCLUSIONS: A f CIS was found in ≈50% of subjects and was a virtual prerequisite for good outcome in this study subgroup of IMS I and II. We call this the 50% barrier.
BACKGROUND AND PURPOSE: The Capillary Index Score (CIS) is a simple angiography-based scale for assessing viable tissue in the ischemic territory. We retrospectively applied it to Interventional Management of Stroke (IMS) trials I and II to evaluate the predictive value for good outcomes. METHODS: CIS was calculated from pretreatment diagnostic cerebral angiograms blinded to outcome. IMS I and II diagnostic cerebral angiogram images of sufficient quality were reviewed and CIS calculated for treated subjects with internal carotid artery or M1 occlusion. CIS scoring (0-3) was dichotomized into favorable (f CIS; 2 or 3) and poor (p CIS; 0 or 1). Modified thrombolysis in cerebral infarction score 2b or 3 was considered good revascularization. CIS and modified thrombolysis in cerebral infarction scores were compared with good outcome, defined as modified Rankin Scale score≤2 at 90 days. RESULTS: Twenty-eight of 161 subjects met the inclusion criteria. Thirteen (46%) had f CIS. Good clinical outcome was significantly different between the 2 CIS groups (62% for f CIS versus 7% for p CIS; P=0.004). Good reperfusion correlated to good outcome (P=0.04). No significant differences in time to intravenous or intra-arterial treatment were identified between f CIS and p CIS groups (P>0.25). CONCLUSIONS: A f CIS was found in ≈50% of subjects and was a virtual prerequisite for good outcome in this study subgroup of IMS I and II. We call this the 50% barrier.
Authors: V Mahajan; P T Minshew; J Khoury; P P Shu; M Muzaffar; T Abruzzo; J L Leach; T A Tomsick Journal: AJNR Am J Neuroradiol Date: 2008-03-20 Impact factor: 3.825
Authors: Wade S Smith; Gene Sung; Jeffrey Saver; Ronald Budzik; Gary Duckwiler; David S Liebeskind; Helmi L Lutsep; Marilyn M Rymer; Randall T Higashida; Sidney Starkman; Y Pierre Gobin; Donald Frei; Thomas Grobelny; Frank Hellinger; Dan Huddle; Chelsea Kidwell; Walter Koroshetz; Michael Marks; Gary Nesbit; Isaac E Silverman Journal: Stroke Date: 2008-02-28 Impact factor: 7.914
Authors: Manoj Jagani; Waleed Brinjikji; Mohammad H Murad; Alejandro A Rabinstein; Harry J Cloft; David F Kallmes Journal: J Vasc Interv Neurol Date: 2017-01
Authors: Feras Akbik; Joshua A Hirsch; Pedro Telles Cougo-Pinto; Ronil V Chandra; Claus Z Simonsen; Thabele Leslie-Mazwi Journal: Curr Treat Options Cardiovasc Med Date: 2016-05