Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke.
10.3340/jkns.2016.0809.003
- Author:
Jae Sang OH
1
;
Seok Mann YOON
;
Jai Joon SHIM
;
Jae Won DOH
;
Hack Gun BAE
;
Kyeong Seok LEE
Author Information
1. Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. smyoonns@gmail.com
- Publication Type:Original Article
- Keywords:
Balloon guiding catheter;
Anterior circulation;
Ischemic stroke;
Thrombectomy;
ICA occlusion
- MeSH:
Carotid Artery, Internal;
Catheters*;
Cerebral Infarction;
Humans;
Multivariate Analysis;
Stents;
Stroke*;
Thrombectomy*
- From:Journal of Korean Neurosurgical Society
2017;60(2):155-164
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke. METHODS: Sixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated. RESULTS: Successful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19: 95% confidence interval, 1.07–25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01). CONCLUSION: A BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.
