Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ and School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.
School for Cardiovascular Diseases Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
Cardiovasc Intervent Radiol. 2024 Jul;47(7):918-928. doi: 10.1007/s00270-024-03718-9. Epub 2024 Apr 19.
Balloon guide catheters (BGCs) are used in endovascular treatment (EVT) for ischemic stroke. Previous literature did not distinguish between BGC use with and without inflated balloon. This study aims to compare outcomes between non-BCG and BGC use with and without inflated balloon during EVT.
Patients who underwent EVT for anterior circulation ischemic stroke between September 2020 and February 2023 were analyzed. Patients were divided into three groups: non-BGC, BGC with inflated balloon, or BGC without inflated balloon. The primary outcome was the ordinal modified Rankin Scale (mRS) at 90-day follow-up. Secondary outcomes included expanded Thrombolysis In Cerebral Ischemia score (eTICI) and periprocedural complications. Regression analyses with BGC with inflated balloon as comparator were performed with adjustments. Subgroup analyses were conducted based on first-line thrombectomy technique.
Out of 511 patients, 428 patients were included. Compared to BCG with inflated balloon, the mRS at 90 days did not differ in the group without inflated balloon (adjusted common [ac]OR: 1.07, 95%CI 0.67-1.73) or non-BGC (acOR: 1.42, 95%CI 0.83-2.42). Compared to patients treated with a BGC with inflated balloon, those treated with BGC without inflated balloon had lower eTICI scores (acOR: 0.59, 95%CI 0.37-0.94), and patients treated with non-BGC had lower chances of periprocedural complications (aOR: 0.41, 95%CI 0.20-0.86).
This study shows no clinical differences in ischemic stroke patients treated with BGC with inflated balloon compared to non-BGC and BGC without inflated balloon, despite lower periprocedural complication rates in the non-BGC group and lower eTICI scores in the BGC without inflated balloon group.
Level 3, non-controlled retrospective cohort study.
球囊引导导管（BGC）用于缺血性卒中的血管内治疗（EVT）。既往文献未区分 BGC 带囊与不带囊使用情况。本研究旨在比较 EVT 中 BGC 带囊与不带囊使用与不使用时的结局。
分析了 2020 年 9 月至 2023 年 2 月期间接受 EVT 的前循环缺血性卒患者。患者分为三组：非 BGC、带囊 BGC 和不带囊 BGC。主要结局为 90 天随访时的改良Rankin 量表（mRS）的 ordinal 评分。次要结局包括扩展血栓溶解脑缺血评分（eTICI）和围手术期并发症。采用 BGC 带囊作为对照进行回归分析，并进行调整。根据一线取栓技术进行亚组分析。
在 511 例患者中，纳入了 428 例患者。与 BGC 带囊相比，不带囊 BGC 组 mRS 评分在 90 天无差异（调整后的共同比值比 [acOR]：1.07，95%CI 0.67-1.73）或非 BGC 组（acOR：1.42，95%CI 0.83-2.42）。与 BGC 带囊治疗的患者相比，不带囊 BGC 治疗的患者 eTICI 评分较低（acOR：0.59，95%CI 0.37-0.94），而非 BGC 治疗的患者围手术期并发症发生率较低（aOR：0.41，95%CI 0.20-0.86）。
本研究表明，在带囊 BGC 与非 BGC 和不带囊 BGC 治疗的缺血性卒中患者中，尽管不带囊 BGC 组的围手术期并发症发生率较低，且不带囊 BGC 组的 eTICI 评分较低，但在带囊 BGC 与非 BGC 治疗的患者中，临床结局无差异。
3 级，非对照回顾性队列研究。
