Title:Effect of Early Balloon Inflation of Balloon Guide Catheter in Mechanical
Thrombectomy for Large Vessel Occlusion
Volume: 20
Issue: 1
Author(s): Beom Mo Kang, Ho Jun Yi*, Dong-Seong Shin and Bum-Tae Kim
Affiliation:
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
- Department
of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
- Department of Neurosurgery,
St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Republic of Korea
Keywords:
Balloon occlusion, ischemic stroke, intervention, reperfusion, thrombectomy, balloon inflation.
Abstract:
Objective: A balloon guide catheter (BGC) is widely used in mechanical thrombectomy
(MT). However, the balloon inflation timing of BGC has not been clearly established. We evaluated
whether balloon inflation timing of BGC affects the results of MT.
Methods: Patients who underwent MT with BGC for anterior circulation occlusion were enrolled.
Patients were dichotomized into early and late balloon inflation groups, according to the timing of
BGC inflation. Angiographic and clinical outcomes were compared between the two groups. Multivariable
analyses were performed to evaluate the predictive factors for first-pass reperfusion
(FPR) and successful reperfusion (SR).
Results: Of 436 patients, the early balloon inflation group showed a shorter procedure time (21
min (11-37) vs. 29 min (14-46), p = 0.014), a higher rate of SR with aspiration only (64.0% vs.
55.4%, p = 0.016), a lower aspiration catheter delivery failure rate (11.1% vs. 19.4%, p = 0.005),
less frequent technique conversion (36.0% vs. 44.5%, p = 0.009), higher rate of FPR (58.2% vs.
50.2%, p = 0.011), and a lower rate of distal embolization (7.9% vs. 11.7%, P = 0.006), compared
to the late balloon inflation group. In multivariate analysis, early balloon inflation was an independent
predictor for FPR (odds ratio, OR 1.53, 95% confidence interval, CI 1.37–2.57; p = 0.011)
and SR (OR 1.26, 95% CI 1.18-1.64; p = 0.018).
Conclusion: Early balloon inflation of BGC enables an effective procedure than late balloon inflation.
Early balloon inflation was associated with higher rates of FPR and SR.
