Stent-retriever alone vs. combined technique with balloon guide catheter in large vessel occlusion stroke: A single center experience

• Published in: Neurology Asia 2024-12, Vol.29 (4), p.953-961
• Main Authors: Dogan, Baki, Akarsu, Fatma Ger, Kocabaş, Zehra Uysal, Aykaç, Özlem, Özdemir, Atilla Özcan
• Format: Article
• Language: English
• ISSN: 1823-6138
• DOI: 10.54029/2024fjj

Background: Today, balloon guide catheters are widely used in thrombectomies. This study aimed to compare the demographic, angiographic, and clinical outcome parameters of thrombectomy for anterior circulation large vessel occlusion strokes (LVOS) using a first-line stent retriever (SR) alone with those of a thrombectomy using a technique combining a balloon guide catheter (BGC) with a distal access catheter (DAC) and an SR. Methods: We retrospectively analyzed the data of patients who had experienced anterior circulation LVOS and underwent mechanical thrombectomy with a BGC at our stroke center between January 2015 and December 2022. The patients were divided into two groups based on the techniques used in the thrombectomy: a stent retriever alone (BGC+SR) and a combined approach (BGC+DAC+SR). Baseline characteristics, procedure details, angiographic results, and clinical outcomes were assessed. The primary clinical outcome in this study was the rate of functional independence (mRS score ≤2) at 90 days. The primary technical outcome was the rate of first pass effect (FPE), defined as achieving near complete/complete revascularization (modified thrombolysis in cerebral infarction [mTICI] 2c-3) after a single treatment pass. Secondary outcomes included mortality at 90 days, procedural complications, embolic complications, and symptomatic intracranial hemorrhage. Results: Out of 234 patients, 137 (58.6%) were in the BGC +SR group, while 97 (41.4%) were in the BGC+SR+DAC group. Patients treated with BGC and SR alone were younger (median age 58 vs. 61 years, p=0.005) and had a higher prevalence of middle cerebral artery occlusions (M1 segment: 64.9% vs. 37.5%; M2 segment: 14.9% vs. 5.2%, p