Topiwala Karan, Quinn Coridon, Mehta Tapan, Masood Kamran, Grande Andrew, Tummala Ramachandra, Jagadeesan Bharathi
Department of Radiology, Neurosurgery and Neurology, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
Interv Neuroradiol. 2024 Feb;30(1):80-85. doi: 10.1177/15910199221104920. Epub 2022 May 30.
Nonrandomized studies have found Balloon Guide Catheter (BGC) use to improve technical and functional outcomes in patients undergoing mechanical thrombectomy (MT).
We performed a retrospective analysis on prospectively collected data of consecutive ischemic stroke patients undergoing MT at our institution (December 2020-October 2021). Interventions where BOBBY BGC (BBGC, ) was used were identified. Baseline demographics and clinico-radiographic characteristics were retrospectively collected and analysed using descriptive statistics.
A total of 43 patients received BBGC-MT (male: female = 26:17, median age 72 years [IQR 62-82]). The most common occlusion site was the middle cerebral artery (MCA) (60.4%). Over half (51.2%) received intravenous thrombolytics. The BBGC tracked well over tortuous aortic arches (type II 34.8%, type III 16.3%), with median arteriotomy-to-perfusion time of 29 min (IQR 20-46). Thromboaspiration was used as first-line MT technique in 69.7% cases, with 1 (IQR 1-2) median MT pass achieving modified TICI (thrombolysis in cerebral ischemia) scores of 3 and 2b/3 in 74.4% and 95.3% respectively. Our overall first pass effect (FPE, defined as mTICI 3 after firs-pass) and modified FPE (defined as, mTICI 2b/3 after first-pass) rates were 51.1% and 79.1% respectively, with rates of 92.3% and 100% respectively when stentretriever and thromboaspiration were combined. The median reduction in National Institutes of Health Stroke Scale (NIHSS) was 9 (IQR 4-15, p < 0.0001), with a median 90-day modified Rankin Score (mRS) of 1.5 (IQR 0-2).
BOBBY BGC use resulted in a high first-pass effect rate and may contribute towards improved functional outcomes.
非随机研究发现，使用球囊导引导管（BGC）可改善接受机械取栓术（MT）患者的技术和功能预后。
我们对在我院（2020年12月至2021年10月）接受MT的连续性缺血性卒中患者的前瞻性收集数据进行了回顾性分析。确定使用BOBBY BGC（BBGC）的干预措施。回顾性收集基线人口统计学和临床影像学特征，并使用描述性统计进行分析。
共有43例患者接受了BBGC-MT（男性：女性=26:17，中位年龄72岁[四分位间距62-82]）。最常见的闭塞部位是大脑中动脉（MCA）（60.4%）。超过一半（51.2%）的患者接受了静脉溶栓治疗。BBGC在迂曲的主动脉弓上跟踪良好（II型34.8%，III型16.3%），动脉切开至灌注的中位时间为29分钟（四分位间距20-46）。69.7%的病例将血栓抽吸作为一线MT技术，中位MT通过次数为1次（四分位间距1-2），分别有74.4%和95.3%的病例实现改良脑缺血溶栓（TICI）评分3分和2b/3分。我们的总体首次通过效果（FPE，定义为首次通过后mTICI 3）和改良FPE（定义为首次通过后mTICI 2b/3）率分别为51.1%和79.1%，当支架取栓器和血栓抽吸联合使用时，率分别为92.3%和100%。美国国立卫生研究院卒中量表（NIHSS）的中位降低值为9（四分位间距4-15，p<0.0001），90天改良Rankin量表（mRS）的中位值为1.5（四分位间距0-2）。
使用BOBBY BGC导致较高的首次通过有效率，并可能有助于改善功能预后。
