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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 
Citation
 Stroke, Vol.50(6) : 1490-1496, 2019 
Journal Title
 Stroke 
ISSN
 0039-2499 
Issue Date
2019
Keywords
balloon occlusion ;  endovascular treatment ; stroke ; thrombectomy
Abstract
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.
Full Text
https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.118.024723
DOI
10.1161/STROKEAHA.118.024723
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170295
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