title: Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Jae-Sang
authors.initials: JS
authors.lastname: Oh
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Seok-Mann
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Jai-Joon
authors.initials: JJ
authors.lastname: Shim
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Doh
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Hack-Gun
authors.initials: HG
authors.lastname: Bae
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Kyeong-Seok
authors.initials: KS
authors.lastname: Lee
keywords: Anterior circulation; Balloon guiding catheter; ICA occlusion; Ischemic stroke; Thrombectomy