Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy
UMass Chan Affiliations
Department of RadiologyDocument Type
Journal ArticlePublication Date
2019-02-02Keywords
ballooncatheter
stroke
technique
thrombectomy
Cardiovascular Diseases
Nervous System Diseases
Neurology
Radiology
Surgery
Surgical Procedures, Operative
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Show full item recordAbstract
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.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
DOI
10.1136/neurintsurg-2018-014452Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48338PubMed ID
30712011Notes
Full author list omitted for brevity. For the full list of authors, see article.
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10.1136/neurintsurg-2018-014452