Article Figures & Data
Figures
- Fig 1.
Patient flow and treatment group designation for 81 subjects entered into IMS II.
- Fig 2.
Graph depicts total cumulative complete grade 3 AOL recanalization at each 15-minute interval for the EKOS Primo sonography microcatheter (n = 29) and the standard microcatheter in IMS II (n = 14). Standard microcatheter recanalization data points at 60 and 120 minutes are also depicted. IMS I data are incomplete at 60 minutes, with 23 confirmed control arteriograms. Sixty- and 120-minute IMS I data points closely approximate the line of IMS II microcatheter recanalization. The open circle emphasizes an early equivalence of standard microcatheter to the sonography (US) microcatheter. The greatest recanalization effect (>20%) is within the first 15 minutes of microcatheter placement.
- Fig 3.
Temperature (T) chart correlation to recanalization in M2 occlusion. Upper left: control arteriogram demonstrates EKOS sonography microcatheter placed in the M2 occlusion (white arrow) just before treatment time 0. Upper right: 15-minute control arteriogram demonstrates microcatheter tip retraction into the M1 segment (white arrow). Note the temperature decrease of approximately 0.2°C during the 15-minute time interval, indicating cooling of the catheter by flowing blood. Lower right: oblique 30-minute arteriogram with catheter-tip position (white arrow) proximal to recanalization of the M2 segment, with distal emboli (AOL 3 recanalization, TICI 2 perfusion). Note the temperature drop of approximately 0.4°C during the 15-minute time interval. The downward spikes of T indicate cooling by contrast injection. The spike at 25 minutes was an additional injection to confirm maintenance of catheter position, where no recanalization was yet identified. deg C indicates degrees celsius.
Tables
- Table 1:
Terminology and definition of TICI reperfusion (I) and AOL recanalization scores (II)*
Terminology and Definition Posttreatment TICI reperfusion grade
0 = No perfusion
1 = Perfusion past the initial obstruction but limited distal branch filling with little or slow distal perfusion
2A = Perfusion of less than half of the vascular distribution of the occluded artery (eg, filling and perfusion through 1 M2 division)
2B = Perfusion of half or greater of the vascular distribution of the occluded artery (eg, filling and perfusion through 2 or more M2 divisions)
3 = Full perfusion with filling of all distal branches
Posttreatment AOL recanalization grade
0 = No recanalization of the occlusion
1 = Incomplete or partial recanalization of the occlusion, with no distal flow
2 = Incomplete or partial recanalization of the occlusion, with any distal flow
3 = Complete recanalization of the occlusion with any distal flow
* The modified TICI reperfusion score was essentially equivalent to TIMI score applied in IMS I, with grade 2 further divided into A and B for post hoc analysis.
- Table 2:
mRS 0–2 outcomes and mortality with 75 ICA T (n = 29) M1 (n = 46) occlusions according to TICI reperfusion and AOL recanalization in IMS I and II*
mRS 0–2 Mortality IMS I IMS II Total I & II IMS I IMS II Total I & II TICI 2/3 10/25 (40%) 11/21 (52.4%) 21/46 (45.6%) P = .0004 4/25 (20%) 1/21 (4.7 %) 5/46 (10.9%) P = .01 No TICI 2/3 0/16 (0%) 2/13 (15.4%) 2/29 (6.9 %) 5/16 (31.3%) 5/13 (38.4%) 10/29 (34.5%) TICI 2B, 3 7/15 (46.7%) 8/11 (72.7%) 15/26 (57.7%) P = .0002 2/15 (13.3%) 0/11 (0%) 2/26 (7.7%) P = .05 No TICI 2B, 3 3/26 (11.5%) 5/23 (21.7 %) 8/49 (16.3 %) 7/26 (25.9%) 6/23 (26.1%) 13/49 (26.5%) AOL 2/3 10/30 (34.5%) 11/26 (42.3%) 21/56 (37.5%) P = .027 5/30 (16.6%) 3/26 (11.5%) 8/56 (14.3%) P = .03 No AOL 2/3 0/11 (0%) 2/8 (25%) 2/19 (10.5%) 4/11 (36.3%) 3/8 (37.5%) 7/19 (36.8%) Overall 10/41 (24.4%) 13/34 (38.2%) 23/75 (30.6%) 9/41 (21.9%) 6/34 (17.6%) 15/75 (20%) * These data includes 25 (33%) subjects with ICA bifurcation occlusion or stenosis ≥ 70%. Statistical comparisons of 3 dichotomized revascularization end points are included.
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