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Combined Aspiration and Stent Retriever Thrombectomy for Distal Carotid Artery Occlusion Using Balloon Guide versus
Ender Uysal1, Bade von Bodelschwingh2, Omer Naci Tabakci2
1Radiology Clinic Antalya, Antalya Training and Research Hospital, University of Health Sciences, Antalya 07100, Turkey.
Insights
Balloon guide catheters (BGCs) and non-balloon guide catheters (NBGCs) showed similar outcomes in acute ischemic stroke treatment. Both methods resulted in comparable improvements in NIHSS scores, recanalization rates, functional outcomes, and mortality.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Endovascular thrombectomy is the standard for acute stroke management.
- Balloon guide catheters (BGCs) offer flow arrest during clot retrieval.
- Comparison of BGCs versus non-balloon guide catheters (NBGCs) in combined stroke treatment is needed.
Purpose of the Study:
- To compare the efficacy and safety of BGCs versus NBGCs in patients with acute ischemic stroke undergoing combined endovascular treatment.
- To evaluate outcomes including neurological deficit, recanalization, functional status, and mortality.
Main Methods:
- Retrospective study of 65 patients with distal internal carotid artery occlusion.
- Patients underwent aspiration and stent retriever thrombectomy.
- Comparison between BGC group (n=27) and NBGC group (n=38).
Main Results:
- No significant difference in NIHSS score change between BGC and NBGC groups.
- Successful recanalization rates were similar between groups (p=0.292).
- No significant differences in three-month functional outcome (p=0.952) or in-hospital mortality (p=0.178).
Conclusions:
- BGCs and NBGCs demonstrate comparable safety and efficacy in combined endovascular stroke treatment.
- Current evidence suggests no significant advantage of BGCs over NBGCs for this patient population.
- Further prospective studies with larger cohorts are recommended to confirm these findings.
Abstract:
Background: The introduction of endovascular thrombectomy dramatically changed acute stroke management and became the standard treatment. Balloon guide catheters provide flow arrest during the clot retrieval process and have several advantages.This study aimed to compare balloon guide catheters (BGCs) versus non-balloon guide catheters (NBGCs) as a part of a combined treatment modality in patients presenting with acute ischemic stroke. Methods: This retrospective study included n = 65 patients who underwent a combined endovascular stroke treatment for distal internal carotid artery (ICA) occlusion. Patients underwent aspiration and stent retriever thrombectomy with the use of BGCs (Group 1, n = 27) or NBGCs (Group 2, n = 38). Results: The groups were compared for outcomes: the National Institutes of Health Stroke Scale (NIHSSS) score change, successful recanalization, good functional outcome at three months, and in-hospital mortality. Conclusion: The two groups didn't differ in terms of the NIHSS score change compared to baseline (p > 0.05). Moreover, there were no significant differences between the two groups in terms of the successful recanalization rate, three-month favorable functional outcome rate, and in-hospital mortality (p = 0.292, p = 0.952, p = 0.178), respectively. Further prospective studies with a larger number of patients and better methodology are warranted.
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