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Updated: May 18, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Revascularization grading in endovascular acute ischemic stroke therapy.

O O Zaidat¹, M A Lazzaro, D S Liebeskind

¹Department of Neurology, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, WI, USA. szaidat@mcw.edu

|September 26, 2012

Summary

Evaluating acute ischemic stroke (AIS) revascularization grading systems is crucial. The Thrombolysis In Cerebral Ischemia (TICI) score is currently the most defined and widely used method for assessing endovascular therapy success.

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Last Updated: May 18, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Area of Science:

Neurology
Interventional Radiology
Vascular Medicine

Background:

Successful endovascular therapy for acute ischemic stroke (AIS) relies on recanalization and reperfusion.
Intravenous recombinant tissue plasminogen activator (rt-PA) may be less effective for large artery occlusions.
Endovascular therapies offer higher recanalization rates, with ongoing trials comparing efficacy.

Purpose of the Study:

To review and critically evaluate current revascularization grading systems used in AIS interventional therapy trials.
To assess the criteria for measurement, reproducibility, ease of use, and clinical outcome correlation of these grading systems.

Main Methods:

A Medline literature search was conducted from 1965 to 2011.
The review focused on parameters required for reporting, interpretation, and comparison of revascularization grading methods.

Main Results:

The Thrombolysis In Cerebral Ischemia (TICI) and Thrombolysis In Myocardial Ischemia (TIMI) scores are the most common grading methods in AIS trials.
The TICI grading system is currently the best defined and most widely used scheme.

Conclusions:

The TICI score is the preferred method for grading revascularization in AIS interventional trials until advanced perfusion studies are available.
Other grading systems can be utilized for research and correlation.
Future research should explore a new scale integrating occlusion, location, and perfusion.