Title
Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy
UMMS Affiliation
Department of Radiology
Publication Date
2019-02-02
Document Type
Article
Disciplines
Cardiovascular Diseases | Nervous System Diseases | Neurology | Radiology | Surgery | Surgical Procedures, Operative
Abstract
INTRODUCTION: The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter.
METHODS: The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. BGC use was at the discretion of the physician.
RESULTS: 536 anterior circulation patients (of whom 279 (52.1%) had BGC placement) were included in this analysis. Baseline characteristics were notable for younger patients in the BGC group (65.4+/-15.3 vs 68.1+/-13.6, P=0.03) and lower rate of hypertension (72% vs 79%, P=0.06). Mean time from symptom onset to groin puncture was longer in the BGC group (357 vs 319 min, P=0.06).Thrombolysis in Cerebral Infarction 2b/3 scores were higher in the BGC cohort (84% vs 75.5%, P=0.01). There was no difference in reperfusion time, first pass effect, number of passes, or rescue therapy. Good clinical outcome at 3 months was superior in patients with BGC (57% vs 40%; P=0.0004) with a lower mortality rate (13% vs 23%, P=0.008). Multivariate analysis demonstrated that BGC use was an independent predictor of good clinical outcome (OR 2; 95% CI 1.3 to 3.1, P=0.001).
CONCLUSIONS: In acute stroke patients presenting with anterior circulation large vessel occlusion, use of a BGC with the Trevo stent retriever resulted in improved reperfusion, improved clinical outcome, and lower mortality.
Keywords
balloon, catheter, stroke, technique, thrombectomy
DOI of Published Version
10.1136/neurintsurg-2018-014452
Source
J Neurointerv Surg. 2019 Feb 2. pii: neurintsurg-2018-014452. doi: 10.1136/neurintsurg-2018-014452. [Epub ahead of print] Link to article on publisher's site
Journal/Book/Conference Title
Journal of neurointerventional surgery
Related Resources
PubMed ID
30712011
Repository Citation
Nguyen TN, Puri AS. (2019). Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy. Radiology Publications. https://doi.org/10.1136/neurintsurg-2018-014452. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/449
Comments
Full author list omitted for brevity. For the full list of authors, see article.