{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:39:52Z","timestamp":1790775592335,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Extended thrombolysis in cerebral infarction (eTICI) 2c\/3 reperfusion after mechanical thrombectomy (MT) is associated with better stroke outcomes than eTICI 2b. Whether additional MT attempt after achieving eTICI 2b (beyond 2b attempt) leads to better outcomes is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Consecutive patients with acute anterior circulation stroke who achieved eTICI 2b during MT were divided into 2 groups: those who further tried MT (beyond\u20102b group) and those without (nonbeyond\u20102b group). The patients who directly achieved eTICI 2c\/3 without experiencing 2b (direct\u20102c\/3 group) were also studied. The outcomes included the reperfusion status, favorable outcome (3\u2010month modified Rankin scale score of 0\u20132), neurological improvement (a \u226510\u2010point decrease of the National Institutes of Health Stroke Scale score from baseline or the score of 0) at 24\u00a0hours and symptomatic intracranial hemorrhage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Of 308 patients, 50 were in the beyond\u20102b group, 87 in the nonbeyond\u20102b group, and the remaining 171 in the direct\u20102c\/3 group. Perfusion of middle cerebral artery branches supplying the primary motor cortex was worse in the beyond\u20102b than the nonbeyond\u20102b group at the time of eTICI 2b (\n              <jats:italic>P<\/jats:italic>\n              =0.007). Favorable outcome was similarly common (48% for each,\n              <jats:italic>P<\/jats:italic>\n              =0.40). Neurological improvement was more frequent (52% versus 37%;\n              <jats:italic>P<\/jats:italic>\n              =0.04) and symptomatic intracranial hemorrhage tended to be more common (6% versus 1%,\n              <jats:italic>P<\/jats:italic>\n              =0.11) in the beyond\u20102b than the nonbeyond\u20102b group. Eighteen patients (36%) in the beyond\u20102b group finally achieved eTICI 2c\/3; 10 of these (56%) and 14 of the remaining 32 (44%) had favorable outcome (\n              <jats:italic>P<\/jats:italic>\n              =0.83). The former rate was similar to that in the direct\u20102c\/3 group (58%;\n              <jats:italic>P<\/jats:italic>\n              =0.99).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients undergoing additional MT attempt after achieving eTICI 2b had numerically but not significantly more symptomatic intracranial hemorrhage and showed a similar level of functional outcome at 3 months than those who did not. When eTICI 2c\/3 was finally achieved by additional attempts, functional outcome was similar with that of patients who directly achieved eTICI 2c\/3 without experiencing 2b.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration Information<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT02251665.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.121.000196","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T14:18:22Z","timestamp":1641997102000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Mechanical Thrombectomy Beyond 2b Reperfusion: Should We Pursue a Higher Reperfusion Grade after Achievement of 2b?"],"prefix":"10.1161","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-2164","authenticated-orcid":false,"given":"Junpei","family":"Koge","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanta","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Stroke Care Unit National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Neurology National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Shiozawa","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Ohta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsu","family":"Satow","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroharu","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Neurology National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000158"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001972"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014127"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.020700"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.028891"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011613"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-015205"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6397"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032799"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1161\/STROKEAHA.119.028787","article-title":"Direct recanalization: a game\u2010changing factor in endovascular treatment of large vessel occlusion strokes","volume":"51","author":"Grac\u00eda \u00c1","year":"2020","unstructured":"Grac\u00eda \u00c1, Rubiera M, Requena M, Muchada M, Pagola J, Rodriguez\u2010Luna D, Deck M, Juega J, Rodr\u00edguez\u2010Villatoro N, Boned S, et\u00a0al. 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