title: Comparison of a Balloon Guide Catheter and a Non-Balloon Guide Catheter for Mechanical Thrombectomy.
abstract: Purpose To evaluate the effectiveness of mechanical thrombectomy with the use of a stent retriever in acute ischemic stroke, performed by using a balloon guide catheter or non-balloon guide catheter. Materials and Methods In accordance with the institutional review board approval obtained at the two participating institutions, retrospective analysis was performed in 183 consecutive patients treated between 2013 and 2014 for occlusions in the middle cerebral artery or carotid terminus by using a stent retriever with a balloon guide catheter (n = 102) at one center and a non-balloon guide catheter (n = 81) at the other center. Data on procedure duration, number of passes, angiographic findings, type of stent retriever used, and expertise of the operators were collected. Successful recanalization was defined as grade 3 or 2b modified Treatment in Cerebral Ischemia recanalization accomplished in up to three passes. Univariate and multivariate subgroup analyses were conducted to control for the confounding variables of prior thrombolysis, location of occlusion, and operator expertise. Results Successful recanalization with the balloon guide catheter was achieved in 89.2% of thrombectomies (91 of 102) versus 67.9% (55 of 81) achieved with the non-balloon guide catheter (P = .0004). The one-pass thrombectomy rate with the balloon guide catheter was significantly higher than for that with the non-balloon guide catheter (63.7% [65 of 102] vs 35.8% [29 of 81], respectively; P = .001). The procedure duration was significantly shorter by using the balloon guide catheter than the non-balloon guide catheter (median, 20.5 minutes vs 41.0 minutes, respectively; P < .0001). Conclusion The effectiveness of mechanical thrombectomy with stent retrievers in acute ischemic stroke in the anterior circulation in terms of angiographic results and procedure duration was improved when performed in combination with the balloon guide catheter. (©) RSNA, 2016.
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Aglaé
authors.initials: A
authors.lastname: Velasco
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Boris
authors.initials: B
authors.lastname: Buerke
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Christian P
authors.initials: CP
authors.lastname: Stracke
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Shoma
authors.initials: S
authors.lastname: Berkemeyer
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Pascal J
authors.initials: PJ
authors.lastname: Mosimann
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schwindt
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Pedro
authors.initials: P
authors.lastname: Alcázar
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Christian
authors.initials: C
authors.lastname: Cnyrim
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Niederstadt
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: René
authors.initials: R
authors.lastname: Chapot
authors.affiliation: From the Department of Clinical Radiology-Neuroradiology (A.V., B.B., S.B., W.S., C.C., T.N., W.H.), University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Muenster, Germany; Department of Intracranial Endovascular Therapy and Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Essen, Germany (C.P.S., R.C.); Department of Neuroradiology and Interventional Neuroradiology, University Hospital Virgen de las Nieves, Granada, Spain (P.A.); and Department of Radiology, University Hospital of Lausanne, Lausanne, Switzerland (P.J.M.).
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057785:Catheters; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult