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

Link to Article in PubMed

PubMed ID

31591997

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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