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Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy

Authors
 Ju-Yu Chueh  ;  Dong-Hun Kang  ;  Byung Moon Kim  ;  Matthew J Gounis 
Citation
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.63(1) : 14-25, 2020-01 
Journal Title
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY
ISSN
 2005-3711 
Issue Date
2020-01
Keywords
Acute stroke ; Balloon occlusion ; Endovascular thrombectomy ; Thrombectomy
Abstract
Proximal flow control achieved with a balloon guide catheter (BGC) during endovascular treatment of acute ischemic stroke is reviewed in this article. In clinical practice, BGCs offer a multi-faceted approach for clot retrieval by creating proximal flow arrest, reducing embolic burden, and shortening procedure time. Evaluation of frontline thrombectomy procedures with BGCs revealed advantages of combined use over the conventional guide catheter (CGC), notably in the significant reduction of distal emboli to both the affected and previously unaffected territories. Recently, new measures of early and complete reperfusion at first thrombectomy pass have been identified as independent predictors of improved outcomes, which were consistently demonstrated with use of BGC as a safe and effective option to minimize number of passes during intervention. Prior randomized controlled trials reported the positive correlation between BGC-treated patients and a lower risk of mortality as well as shortened procedure time. While BGC use is more common in stent retriever-mediated mechanical thrombectomy, preliminary data has shown the potential benefit of device application during contact aspiration thrombectomy to achieve successful recanalization. However, the question of which major endovascular strategy reigns superior as a frontline remains to be answered. Along with clinical case assessments, BGC performance during in-vitro simulation was analyzed to further understand mechanisms for optimization of thrombectomy technique.
Files in This Item:
T9992020537.pdf Download
DOI
10.3340/jkns.2019.0114
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190312
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