Prognostic Value of Reperfusion Quality Assessed by Tici Score in Patients With Low Alberta Stroke Program Early Ct Score Ischemic Stroke: A Systematic Review and Meta-Analysis

Purpose This systematic review and meta-analysis aimed to evaluate the impact of reperfusion quality on clinical outcomes in low Alberta Stroke Program Early CT-Score stroke patients. Method A systematic search of PubMed, Google Scholar, and the Cochrane Library (January 2005 to August 2025) identified studies involving adult patients with low-ASPECTS stroke undergoing endovascular thrombectomy with outcomes stratified by mTICI grade. Random-effects models were used to calculate pooled risk ratios (RRs) and mean differences (MDs). Results Eight studies (2,780 patients) were included. Complete reperfusion was associated with a significantly lower risk of mortality compared with partial reperfusion (RR = 0.67, 95% CI 0.59–0.77; P < 0.00001; I 2 = 36%). For intracranial hemorrhage, six studies (2,192 patients) showed no significant difference between groups (RR = 0.72, 95% CI 0.44–1.19; P = 0.20; I 2 = 52%). Analysis of favorable outcome (mRS below 2; six studies, 2,193 patients) showed significantly higher rates with mTICI 3 (RR = 2.4, 95% CI 1.41–4.07; P = 0.0009; I 2 = 68%). Conclusion Complete reperfusion is associated with reduced mortality and improved functional outcomes without increasing bleeding risk in low-ASPECTS stroke patients.