Background and Purpose: Successful reperfusion
therapy is supposed to be comprehensive and validated beyond the grade of recanalization. This study aimed to develop a novel scoring system for defining the successful recanalization after endovascular
thrombectomy. Methods: We analyzed the data of consecutive
acute stroke patients who were eligible to undergo reperfusion
therapy within 24 h of onset and who underwent mechanical
thrombectomy using a nationwide multicenter
stroke registry. A new score was produced using the predictors which were directly linked to the procedure to evaluate the performance of the
thrombectomy procedure. Results: In total, 446 patients in the training population and 222 patients in the validation population were analyzed. From the potential components of the score, four items were selected: Emergency Room-to-
puncture time (T), adjuvant devices used (A), procedural intracranial
bleeding (B), and post-
thrombectomy reperfusion status [Thrombolysis in
Cerebral Infarction (TICI)]. Using these items, the TAB-TICI score was developed, which showed good performance in terms of discriminating early neurological aggravation [AUC 0.73, 95% confidence interval (CI) 0.67-0.78, P < 0.01] and favorable outcomes (AUC 0.69, 95% CI 0.64-0.75, P < 0.01) in the training population. The stability of the TAB-TICI score was confirmed by external validation and sensitivity analyses. The TAB-TICI score and its derived grade of successful recanalization were significantly associated with the volume of
thrombectomy cases at each site and in each admission year. Conclusion: The TAB-TICI score is a valid and easy-to-use tool to more comprehensively define successful recanalization after endovascular
thrombectomy in
acute stroke patients with large vessel occlusion.