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Updated: Nov 12, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Usefulness of combination usage of balloon guide catheter with contact aspiration thrombectomy
Yong-Won Kim1, Dong-Hun Kang2,3, Wonsoo Son2
1Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Insights
Balloon guide catheter (BGC) use improves outcomes for contact aspiration thrombectomy (CAT) in stroke patients, especially for proximal occlusions and cardioembolic strokes, leading to better reperfusion and fewer complications.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Contact aspiration thrombectomy (CAT) is a frontline treatment for acute ischemic stroke.
- Angiographic outcomes of CAT can be influenced by factors like balloon guide catheter (BGC) use, stroke etiology, and occlusion location.
Purpose of the Study:
- To analyze conditional outcomes of CAT.
- To determine factors that maximize angiographic benefits of CAT.
Main Methods:
- Retrospective analysis of 160 patients undergoing CAT for anterior circulation occlusive stroke (Jan 2017-Dec 2018).
- Comparison of angiographic and clinical outcomes based on BGC use, stroke etiology, and occlusion location.
- Multivariable analyses for first-pass reperfusion (FPR) and favorable clinical outcome.
Main Results:
- Rates: FPR 43.1%, successful reperfusion 58.1%, final reperfusion 81.9%, favorable clinical outcome 60.6%.
- BGC use correlated with higher FPR, successful reperfusion, lower distal embolization, and faster reperfusion.
- Subgroup analysis showed BGC benefits in ICA, MCA M1 occlusions, and cardioembolism.
Conclusions:
- BGC usage in CAT is associated with improved angiographic outcomes, including higher FPR, successful reperfusion, and reduced distal embolization.
- BGC use is particularly beneficial for proximal occlusions and cardioembolic strokes, maximizing CAT's efficacy.
- BGC is an independent predictor of FPR in CAT.
Background:
Angiographic outcomes of contact aspiration thrombectomy (CAT), a frontline thrombectomy strategy, can vary depending on balloon guide catheter (BGC) usage, stroke etiology, and occlusion location. The purpose of this study was to analyze conditional outcomes of CAT to determine which result in maximum angiographic benefits.
Methods:
Patients who received CAT for anterior circulation occlusive stroke between January 2017 and December 2018 were included. Angiographic and clinical outcomes were compared relative to BGC use, stroke etiology, and occlusion location. Multivariable analyses for first-pass reperfusion (FPR) and favorable clinical outcome were performed.
Results:
Of 160 included patients, the rates of FPR, successful reperfusion after CAT, final successful reperfusion, and favorable clinical outcome were 43.1%, 58.1%, 81.9%, and 60.6%, respectively. BGC use was associated with a higher rate of FPR, successful reperfusion after CAT, a lower rate of distal embolization, and faster reperfusion. Based on subgroup analysis, BGC usage in ICA, MCA M1 occlusion, and cardioembolism were associated with higher FPR, successful reperfusion after CAT, and lower distal embolization. Faster reperfusion was achieved in ICA occlusions and cardioembolisms. BGC usage was an independent predictor of FPR. Favorable clinical outcome was associated with male gender, low initial NIHSS score, fast onset to reperfusion, and FPR.
Conclusions:
In CAT, BGC usage was associated with better angiographic outcomes, including higher FPR, successful reperfusion after CAT, prevention of distal embolization, and faster reperfusion, especially in proximal occlusions and cardioembolisms. These conditions may play a role in maximizing the benefits of CAT.
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