Balloon Guide Catheter Is Beneficial in Endovascular Treatment Regardless of Mechanical Recanalization Modality
Authors
Jang-Hyun Baek ; Byung Moon Kim ; Dong-Hun Kang ; Ji Hoe Heo ; Hyo Suk Nam ; Young Dae Kim ; Yang-Ha Hwang ; Yong-Won Kim ; Yong-Sun Kim ; Dong Joon Kim ; Hyo Sung Kwak ; Hong Gee Roh ; Young-Jun Lee ; Sang Heum Kim ; Seung Kug Baik ; Pyoung Jeon ; Joonsang Yoo ; Sang Hyun Suh ; Byungjun Kim ; Jin Woo Kim ; Sangil Suh ; Hong-Jun Jeon
Background and Purpose—Based on its mechanism, the use of balloon guide catheters (BGCs) may be beneficial during
endovascular treatment, regardless of the type of mechanical recanalization modality used—stent retriever thrombectomy
or thrombaspiration. We evaluated whether the use of BGCs can be beneficial regardless of the first-line mechanical
endovascular modality used.
Methods—We retrospectively reviewed consecutive acute stroke patients who underwent stent retriever thrombectomy or
thrombaspiration from the prospectively maintained registries of 17 stroke centers nationwide. Patients were assigned
to the BGC or non-BGC group based on the use of BGCs during procedures. Endovascular and clinical outcomes were
compared between the BGC and non-BGC groups. To adjust the influence of the type of first-line endovascular modality
on successful recanalization and favorable outcome, multivariable analyses were also performed.
Results—This study included a total of 955 patients. Stent retriever thrombectomy was used as the first-line modality in 526
patients (55.1%) and thrombaspiration in 429 (44.9%). BGC was used in 516 patients (54.0%; 61.2% of stent retriever
thrombectomy patients; 45.2% of thrombaspiration patients). The successful recanalization rate was significantly higher
in the BGC group compared with the non-BGC group (86.8% versus 74.7%, respectively; P<0.001). Furthermore, the
first-pass recanalization rate was more frequent (37.0% versus 14.1%; P<0.001), and the number of device passes was
fewer in the BGC group (2.5±1.9 versus 3.3±2.1; P<0.001). The procedural time was also shorter in the BGC group
(54.3±27.4 versus 67.6±38.2; P<0.001). The use of BGC was an independent factor for successful recanalization (odds
ratio, 2.18; 95% CI, 1.54–3.10; P<0.001) irrespective of the type of first-line endovascular modality used. The use of
BGC was also an independent factor for a favorable outcome (odds ratio, 1.40; 95% CI, 1.02–1.92; P=0.038) irrespective
of the type of first-line endovascular modality used.
Conclusions—Regardless of the first-line mechanical endovascular modality used, the use of BGC in endovascular treatment
was beneficial in terms of both recanalization success and functional outcome.