Effect of balloon guide catheter utilization on contact aspiration thrombectomy

Dong Hun Kang, Byung Moon Kim, 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

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4 Citations (Scopus)

Abstract

OBJECTIVE The role of the balloon guide catheter (BGC) has not been evaluated in contact aspiration thrombectomy (CAT) for acute stroke. Here, the authors aimed to test whether the BGC was associated with recanalization success and good functional outcome in CAT. METHODS All patients who had undergone CAT as the first-line treatment for anterior circulation intracranial large vessel occlusion were retrospectively identified from prospectively maintained registries for six stroke centers. The patients were dichotomized into BGC utilization and nonutilization groups. Clinical findings, procedural details, and recanalization success rates were compared between the two groups. Whether the BGC was associated with recanalization success and functional outcome was assessed. RESULTS A total of 429 patients (mean age 68.4 ± 11.4 years; M/F ratio 215:214) fulfilled the inclusion criteria. A BGC was used in 45.2% of patients. The overall recanalization and good outcome rates were 80.2% and 52.0%, respectively. Compared to the non-BGC group, the BGC group had a significantly reduced number of CAT passes (2.6 ± 1.6 vs 3.4 ± 1.5), shorter puncture-to-recanalization time (56 ± 27 vs 64 ± 35 minutes), lower need for the additional use of thrombolytics (1.0% vs 8.1%), and less embolization to a distal or different site (0.5% vs 3.4%). The BGC group showed significantly higher final (89.2% vs 72.8%) and first-pass (24.2% vs 8.1%) recanalization success rates. After adjustment for potentially associated factors, BGC utilization remained independently associated with recanalization (OR 4.171, 95% CI 1.523-11.420) and good functional outcome (OR 2.103, 95% CI 1.225-3.612). CONCLUSIONS BGC utilization significantly increased the final and first-pass recanalization rates and remained independently associated with recanalization success and good functional outcome.

Original languageEnglish
Pages (from-to)1494-1500
Number of pages7
JournalJournal of neurosurgery
Volume131
Issue number5
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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    Kang, D. H., Kim, B. M., Heo, J. H., Nam, H. S., Kim, Y. D., Hwang, Y. H., Kim, Y. W., Kim, Y. S., Kim, D. J., Kwak, H. S., Roh, H. G., Lee, Y. J., & Kim, S. H. (2019). Effect of balloon guide catheter utilization on contact aspiration thrombectomy. Journal of neurosurgery, 131(5), 1494-1500. https://doi.org/10.3171/2018.6.JNS181045