Background: The benefit of balloon guide catheter (BGC) use in endovascular thrombectomy (EVT) of patients with acute ischemic stroke remains uncertain. This study assessed the influence of BGC use during EVT on first pass (FP) and revascularization (RV) success in a cohort of stroke patients from a multi-hospital health system. Methods: Patients with anterior circulation large vessel occlusion (LVO) undergoing EVT with stent-retriever or aspiration between 2012 and 2018 at three Kaiser Permanente Southern California (KPSC) region hospitals were identified. A chi-squared test compared the relationship of BGC use with the primary outcomes of FP and RV success using a dichotomized thrombolysis in cerebral infarction (TICI) score of 2b or greater. Results: 218 patients were included. 35 (16%) underwent EVT with BGC. FP success rate did not significantly differ with 37.1% (95% CI 21.5% to 55.1%) FP success in patients that received EVT with BGC and 41.5% (95% CI 34.3% to 49.0%) in patients that received EVT without BGC (p = 0.71). Successful final RV did not significantly differ between the two groups with 85.7% (95% CI 69.7% to 95.2%) final RV success in the EVT with BGC group and 88.5% (95% CI 83.0% to 92.8%) in the EVT without BGC group (p = 0.78). There was no significant difference in FP (p = 0.88) or RV success (p = 0.42) between the BGC (37% FP and 86% RV), non-BGC stent-retriever (42% FP and 92% RV), and aspiration thrombectomy groups (41% FP and 86% RV). Conclusion: There was no observed association between BGC use in EVT of anterior circulation LVO and rates of first pass revascularization or final revascularization.
Introduction The use of balloon guide catheters (BGC) during endovascular thrombectomy (EVT) has been suggested to lower the risk of distal embolization and improve first pass revascularization rates in patients with acute ischemic stroke. However, a recent large randomized controlled trial suggests there is no significant difference in initial and final revascularization scores among EVT performed with a BGC versus without. We assessed the influence of BGC use during EVT on first pass (FP) and revascularization (RV) success in a historical database from a multi‐hospital health system. Methods Patients with anterior circulation large vessel occlusion undergoing EVT with stent‐retriever or aspiration between 2012 and 2018 at three Kaiser Permanente Southern California (KPSC) region hospitals were identified from the database. BGC use was determined through manual chart review. A chi‐squared test compared the relationship of BGC use with the primary outcomes. The primary outcomes were FP and RV success using a dichotomized TICI score of 2b or greater. Results 218 patients were included in the study. BGC was used in 35/218 (16%) of patients. There was no significant difference in age (p = 0.65), gender (p = 0.92), presenting NIHSS (p = 0.45), hypertension (p = 0.66), diabetes (p = 0.85), atrial fibrillation (p = 0.36), serum glucose (p = 0.43), or pre‐EVT TPA administration (p = 0.36). Among EVT with BGC, FP success was 13/35 (37%) and EVT without BGC had a FP success of 76/183 (42%); p = 0.71. Successful final RV with BGC occurred in 30/35 (86%) while EVT without BGC had a successful final RV of 162/183 (89%); p = 0.78. Because BGC use occurred only with stent‐retriever treatment, subgroup analysis was performed comparing the BGC group (N = 35) with the non‐BGC stent‐retriever (N = 88) and aspiration thrombectomy (N = 95) groups. There was no significant difference in FP (p = 0.88) or RV success (p = 0.42) between the BGC (37% FP and 86% RV), non‐BGC stent‐retriever (42% FP and 92% RV), and aspiration thrombectomy groups (41% FP and 86% RV). Conclusions Among our population, BGC use was not associated with higher first pass or final revascularization success.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.