Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success.
Introduction The use of balloon guide catheters (BGC) during endovascular thrombectomy (EVT) has been suggested to lower the risk of distal embolization and improve first pass revascularization rates in patients with acute ischemic stroke. However, a recent large randomized controlled trial suggests...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | Stroke: Vascular and Interventional Neurology |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.158 |
| _version_ | 1797803573261631488 |
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| author | Michael D Modzelewski Conrad W Liang Sabrina M Perlman Mark Duggan Harjyot Toor Sunil A Sheth Evelin Duran Martinez Kuo Chao Lei Feng Mazen Noufal Binh V Nguyen Pankaj J Mowji Navdeep Sangha |
| author_facet | Michael D Modzelewski Conrad W Liang Sabrina M Perlman Mark Duggan Harjyot Toor Sunil A Sheth Evelin Duran Martinez Kuo Chao Lei Feng Mazen Noufal Binh V Nguyen Pankaj J Mowji Navdeep Sangha |
| author_sort | Michael D Modzelewski |
| collection | DOAJ |
| description | Introduction The use of balloon guide catheters (BGC) during endovascular thrombectomy (EVT) has been suggested to lower the risk of distal embolization and improve first pass revascularization rates in patients with acute ischemic stroke. However, a recent large randomized controlled trial suggests there is no significant difference in initial and final revascularization scores among EVT performed with a BGC versus without. We assessed the influence of BGC use during EVT on first pass (FP) and revascularization (RV) success in a historical database from a multi‐hospital health system. Methods Patients with anterior circulation large vessel occlusion undergoing EVT with stent‐retriever or aspiration between 2012 and 2018 at three Kaiser Permanente Southern California (KPSC) region hospitals were identified from the database. BGC use was determined through manual chart review. A chi‐squared test compared the relationship of BGC use with the primary outcomes. The primary outcomes were FP and RV success using a dichotomized TICI score of 2b or greater. Results 218 patients were included in the study. BGC was used in 35/218 (16%) of patients. There was no significant difference in age (p = 0.65), gender (p = 0.92), presenting NIHSS (p = 0.45), hypertension (p = 0.66), diabetes (p = 0.85), atrial fibrillation (p = 0.36), serum glucose (p = 0.43), or pre‐EVT TPA administration (p = 0.36). Among EVT with BGC, FP success was 13/35 (37%) and EVT without BGC had a FP success of 76/183 (42%); p = 0.71. Successful final RV with BGC occurred in 30/35 (86%) while EVT without BGC had a successful final RV of 162/183 (89%); p = 0.78. Because BGC use occurred only with stent‐retriever treatment, subgroup analysis was performed comparing the BGC group (N = 35) with the non‐BGC stent‐retriever (N = 88) and aspiration thrombectomy (N = 95) groups. There was no significant difference in FP (p = 0.88) or RV success (p = 0.42) between the BGC (37% FP and 86% RV), non‐BGC stent‐retriever (42% FP and 92% RV), and aspiration thrombectomy groups (41% FP and 86% RV). Conclusions Among our population, BGC use was not associated with higher first pass or final revascularization success. |
| first_indexed | 2024-03-13T05:22:54Z |
| format | Article |
| id | doaj.art-0cd515c23bf0465f8e20a0b7d6ad5ce3 |
| institution | Directory Open Access Journal |
| issn | 2694-5746 |
| language | English |
| last_indexed | 2024-03-13T05:22:54Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj.art-0cd515c23bf0465f8e20a0b7d6ad5ce32023-06-15T10:40:48ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-03-013S110.1161/SVIN.03.suppl_1.158Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success.Michael D Modzelewski0Conrad W Liang1Sabrina M Perlman2Mark Duggan3Harjyot Toor4Sunil A Sheth5Evelin Duran Martinez6Kuo Chao7Lei Feng8Mazen Noufal9Binh V Nguyen10Pankaj J Mowji11Navdeep Sangha12Kaiser Permanente School of Medicine Pasadena California United States of AmericaDepartment of Neurosurgery Kaiser Permanente Fontana Medical Center Fontana California United States of AmericaKaiser Permanente School of Medicine Pasadena California United States of AmericaKaiser Permanente School of Medicine Pasadena California United States of AmericaDepartment of Neurosurgery Kaiser Permanente Fontana Medical Center Fontana California United States of AmericaUTHealth McGovern Medical School Houston Texas United States of AmericaPomona College Claremont California United States of AmericaDepartment of Radiology Kaiser Permanente Los Angeles Medical Center Los Angeles California United States of AmericaDepartment of Radiology Kaiser Permanente Los Angeles Medical Center Los Angeles California United States of AmericaDepartment of Neurosurgery Kaiser Permanente Fontana Medical Center Fontana California United States of AmericaDepartment of Radiology Kaiser Permanente Anaheim Medical Center Anaheim California United States of AmericaDepartment of Radiology Kaiser Permanente Anaheim Medical Center Anaheim California United States of AmericaDepartment of Neurology Kaiser Permanente Los Angeles Medical Center Los Angeles California United States of AmericaIntroduction The use of balloon guide catheters (BGC) during endovascular thrombectomy (EVT) has been suggested to lower the risk of distal embolization and improve first pass revascularization rates in patients with acute ischemic stroke. However, a recent large randomized controlled trial suggests there is no significant difference in initial and final revascularization scores among EVT performed with a BGC versus without. We assessed the influence of BGC use during EVT on first pass (FP) and revascularization (RV) success in a historical database from a multi‐hospital health system. Methods Patients with anterior circulation large vessel occlusion undergoing EVT with stent‐retriever or aspiration between 2012 and 2018 at three Kaiser Permanente Southern California (KPSC) region hospitals were identified from the database. BGC use was determined through manual chart review. A chi‐squared test compared the relationship of BGC use with the primary outcomes. The primary outcomes were FP and RV success using a dichotomized TICI score of 2b or greater. Results 218 patients were included in the study. BGC was used in 35/218 (16%) of patients. There was no significant difference in age (p = 0.65), gender (p = 0.92), presenting NIHSS (p = 0.45), hypertension (p = 0.66), diabetes (p = 0.85), atrial fibrillation (p = 0.36), serum glucose (p = 0.43), or pre‐EVT TPA administration (p = 0.36). Among EVT with BGC, FP success was 13/35 (37%) and EVT without BGC had a FP success of 76/183 (42%); p = 0.71. Successful final RV with BGC occurred in 30/35 (86%) while EVT without BGC had a successful final RV of 162/183 (89%); p = 0.78. Because BGC use occurred only with stent‐retriever treatment, subgroup analysis was performed comparing the BGC group (N = 35) with the non‐BGC stent‐retriever (N = 88) and aspiration thrombectomy (N = 95) groups. There was no significant difference in FP (p = 0.88) or RV success (p = 0.42) between the BGC (37% FP and 86% RV), non‐BGC stent‐retriever (42% FP and 92% RV), and aspiration thrombectomy groups (41% FP and 86% RV). Conclusions Among our population, BGC use was not associated with higher first pass or final revascularization success.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.158 |
| spellingShingle | Michael D Modzelewski Conrad W Liang Sabrina M Perlman Mark Duggan Harjyot Toor Sunil A Sheth Evelin Duran Martinez Kuo Chao Lei Feng Mazen Noufal Binh V Nguyen Pankaj J Mowji Navdeep Sangha Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success. Stroke: Vascular and Interventional Neurology |
| title | Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success. |
| title_full | Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success. |
| title_fullStr | Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success. |
| title_full_unstemmed | Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success. |
| title_short | Abstract Number ‐ 158: Balloon Guide Catheter Effect on First Pass and Revascularization Success. |
| title_sort | abstract number 158 balloon guide catheter effect on first pass and revascularization success |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_1.158 |
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