Short-term clinical outcomes of balloon-assisted thrombectomy for acute middle cerebral artery occlusive

This study aimed to evaluate the short-term efficacy and safety of balloon-assisted thrombectomy (BAT) for acute middle cerebral artery (MCA) occlusion caused by thrombus superimposed on intracranial atherosclerotic stenosis via a retrospective analysis.

From January 2023 to July 2025, 341 consecutive stroke patients who underwent endovascular therapy at the Department of Neurology, Dongguan Hospital of Traditional Chinese Medicine were initially screened. According to predefined inclusion and exclusion criteria, 45 patients were selected for the final analysis. All included patients received vessel recanalization using the BAT technique. Baseline demographic and clinical data were recorded. Short-term outcomes, procedural metrics, safety endpoints, and economic/technical aspects were assessed.

A total of 45 patients treated with BAT were analyzed. Procedural outcomes demonstrated a first-pass mTICI ≥2b recanalization rate of 75.56%, and final mTICI 2b-3 was achieved in 100% of patients. Median puncture-to-recanalization time was 35 min (23.50-51.00). Clinical and safety outcomes at 90 days showed a modified Rankin Scale (mRS) of 0-2 (independent) in 73.33% and an optimal EQ-5D-5L health state in 42.22%; all-cause mortality was 2.22%. Logistic regression analysis indicated that puncture-to-reperfusion time was the only independent predictor of a favorable 90-day clinical outcome (mRS $\le$ 2) after BAT (OR = 0.878, 95% CI: 0.793-0.973, p < 0.01). Economically, BAT reduced resource utilization by streamlining procedural steps and decreasing intraoperative stent deployment.

Balloon-assisted thrombectomy for acute MCA occlusion due to thrombus on stenotic lesions achieves efficient vessel recanalization with low complication rates and favorable short-term functional outcomes, while offering economic advantages. BAT may represent a preferred endovascular strategy for this subset of complex lesions.