Journal article
Angiographic and clinical outcomes following endovascular thrombectomy for anterior circulation ischemic stroke: impact of balloon guide catheter utilization
Journal of neurointerventional surgery
03/03/2026
DOI: 10.1136/jnis-2025-024795
PMID: 41775536
Abstract
BackgroundPrevious studies favoring the use of balloon guide catheters (BGCs) during endovascular thrombectomy for anterior circulation acute ischemic stroke either predate advancements in catheter technology or inadequately adjust for large-bore aspiration catheters. This study compared angiographic and clinical outcomes for stroke thrombectomy performed without and with BGCs.MethodsThis multicenter, retrospective study analyzed matched anterior circulation thrombectomy cases performed between February 2018 and February 2024. BGC and non-BGC cases were 1:1 matched by demographic and clinical variables. Primary outcome measures were successful reperfusion (modified thrombolysis in cerebral infarction ≥2B) and good clinical outcome (modified Rankin Scale score 0–2 at discharge and 30 days).ResultsAmong 407 patients (non-BGC=199, BGC=208), BGC use had higher rates of successful reperfusion (83.9% vs 90.9%, P=0.034) and better functional outcomes at discharge (18.7% vs 28.4%, P=0.022) and 30 days (21.1% vs 31.3%, P=0.020). On multivariable analysis, BGC independently predicted successful reperfusion (OR 2.29, 95% CI 1.56 to 3.77, P=0.02) and good outcomes at discharge (OR 1.87, 95% CI 1.14 to 3.07, P=0.01) and 30 days (OR 1.89, 95% CI 1.18 to 3.03, P=0.01). Subgroup analysis demonstrated that BGC use was most beneficial in patients with times from last known well to puncture ≤6 hours, with higher rates of successful reperfusion (84.5% vs 94.6%, P=0.041) and favorable outcomes at discharge (14.5% vs 32.4%, P=0.007) and 30 days (23.8% vs 39.2%, P=0.037).ConclusionBGC use during endovascular thrombectomy is associated with higher rates of successful reperfusion and better early functional outcomes, particularly in patients treated within 6 hours of last-known-well time.
Details
- Title: Subtitle
- Angiographic and clinical outcomes following endovascular thrombectomy for anterior circulation ischemic stroke: impact of balloon guide catheter utilization
- Creators
- Diwas Gautam - University of UtahMatthew C Findlay - University of UtahJackson Aubrey - University of UtahJulian Brown - University of UtahMichael T Bounajem - University of UtahDanielle C Brown - Cooper Medical School of Rowan UniversityManisha Koneru - Cooper Medical School of Rowan UniversityLeonardo Cruz-Criollo - University of IowaAnderson Brito Alvarado - University of Iowa Health CareRobert C Rennert - University of UtahCraig J Kilburg - University of UtahKarol P Budohoski - University of UtahEdgar A Samaniego - University of IowaAjith J Thomas - Cooper University Health CareSantiago Ortega-Gutierrez - University of Iowa Hospitals and ClinicsDaniel A Tonetti - Cooper University Health CareRamesh Grandhi - University of Utah
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery
- DOI
- 10.1136/jnis-2025-024795
- PMID
- 41775536
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Electronic publication date
- 03/03/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985141960202771
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