UMMS Affiliation
Department of Radiology, New England Center for Stroke Research
Publication Date
2019-10-08
Document Type
Article
Disciplines
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Cardiovascular Diseases | Nervous System Diseases | Radiology
Abstract
Proximal flow control achieved with a balloon guide catheter (BGC) during endovascular treatment of acute ischemic stroke is reviewed in this article. In clinical practice, BGCs offer a multi-faceted approach for clot retrieval by creating proximal flow arrest, reducing embolic burden, and shortening procedure time. Evaluation of frontline thrombectomy procedures with BGCs revealed advantages of combined use over the conventional guide catheter (CGC), notably in the significant reduction of distal emboli to both the affected and previously unaffected territories. Recently, new measures of early and complete reperfusion at first thrombectomy pass have been identified as independent predictors of improved outcomes, which were consistently demonstrated with use of BGC as a safe and effective option to minimize number of passes during intervention. Prior randomized controlled trials reported the positive correlation between BGC-treated patients and a lower risk of mortality as well as shortened procedure time. While BGC use is more common in stent retriever-mediated mechanical thrombectomy, preliminary data has shown the potential benefit of device application during contact aspiration thrombectomy to achieve successful recanalization. However, the question of which major endovascular strategy reigns superior as a frontline remains to be answered. Along with clinical case assessments, BGC performance during in-vitro simulation was analyzed to further understand mechanisms for optimization of thrombectomy technique.
Keywords
Acute stroke, Balloon occlusion, Endovascular thrombectomy, Thrombectomy
Rights and Permissions
Copyright © 2019 The Korean Neurosurgical Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI of Published Version
10.3340/jkns.2019.0114
Source
J Korean Neurosurg Soc. 2019 Oct 8. doi: 10.3340/jkns.2019.0114. [Epub ahead of print] Link to article on publisher's site
Journal/Book/Conference Title
Journal of Korean Neurosurgical Society
Related Resources
PubMed ID
31591997
Repository Citation
Chueh J, Kang D, Kim BM, Gounis MJ. (2019). Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy. Open Access Articles. https://doi.org/10.3340/jkns.2019.0114. Retrieved from https://escholarship.umassmed.edu/oapubs/4017
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Included in
Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons, Cardiovascular Diseases Commons, Nervous System Diseases Commons, Radiology Commons