Journal article
Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy
Journal of neurointerventional surgery, v 11(9), pp 861-865
Sep 2019
PMID: 30712011
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
IntroductionThe 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.MethodsThe 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.Results536 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).ConclusionsIn 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.
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Details
- Title
- Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy
- Creators
- Thanh N Nguyen - Boston UniversityAlicia C Castonguay - University of ToledoRaul G Nogueira - Emory UniversityDiogo C Haussen - Emory UniversityJoey D English - California Pacific Medical CenterSudhakar R Satti - Christiana Care Health SystemJennifer Chen - Kimmel Cancer CenterHamed Farid - St. Jude Medical CenterCandace Borders - UC Irvine HealthErol Veznedaroglu - Neurosciences InstituteMandy J Binning - Neurosciences InstituteAjit S Puri - University of Massachusetts Medical SchoolNirav A Vora - Department of Radiology, Riverside Radiology and Interventional Associates Inc, Columbus, Ohio, USA.Ron F Budzik - Department of Radiology, Riverside Radiology and Interventional Associates Inc, Columbus, Ohio, USA.Guilherme Dabus - Department of Neurointerventional Surgery, Baptist Cardiac and Vascular Institute, Miami, Florida, USA.Italo Linfante - Department of Neurointerventional Surgery, Baptist Cardiac and Vascular Institute, Miami, Florida, USA.Vallabh Janardhan - The Texas Heart InstituteAmer Alshekhlee - Saint Louis UniversityMichael G Abraham - University of Kansas Medical CenterRandall C Edgell - Saint Louis UniversityM Asif Taqi - Los Robles Hospital & Medical CenterRamy El Khoury - Tulane UniversityMaxim Mokin - University of South FloridaAniel Q Majjhoo - Wayne State UniversityMouhammed R Kabbani - Gundersen Health SystemMichael T Froehler - Vanderbilt University Medical CenterIra Finch - John Muir HealthSameer A Ansari - Northwestern UniversityRoberta Novakovic - Southwestern Medical CenterMohamad Abdalkader - Boston UniversityOsama O Zaidat - Mercy St. Vincent Medical Center
- Publication Details
- Journal of neurointerventional surgery, v 11(9), pp 861-865
- Publisher
- British Medical Journal (BMJ)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000490293400005
- Scopus ID
- 2-s2.0-85061097432
- Other Identifier
- 991019168567604721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Neuroimaging
- Surgery