Journal article
Balloon guide catheter impact on angiographic and clinical outcomes in distal medium vessel occlusion stroke thrombectomy
Journal of neurointerventional surgery, Vol.18(3), pp.639-646
03/2026
DOI: 10.1136/jnis-2025-023138
PMID: 40274405
Abstract
The use of balloon guide catheter (BGC) has been associated with better reperfusion and clinical outcomes in mechanical thrombectomy (MT) for large vessel occlusion stroke. However, the impact of BGC on angiographic and clinical outcomes in patients with distal medium vessel occlusion (DMVO) strokes undergoing MT has not been extensively investigated.
This is a retrospective analysis of a prospectively collected database from 14 comprehensive stroke centers in the United States and Europe. Patients with anterior circulation DMVO due to middle cerebral artery (MCA) M3/M4 or anterior cerebral artery (ACA) A1/A2-3 were included. The cohort was divided into BGC and non-BGC groups. Multivariable logistic regression and inverse probability of treatment weighting (IPTW) were used for comparison. The primary outcome was first pass effect (FPE) defined as modified treatment in cerebral infarction (mTICI) grade 2C/3 after single device pass.
Among 199 patients who were eligible for analysis, 81 (40.7%) were female. The median age was 69 (60-81) years, and National Institutes of Health Stroke Scale score was 13 (7-18). The BGC group (n=73) had higher rates of FPE (53.4% vs 13.7%; IPTW aOR 5.63, 95%CI (2.43 to 13.10), P<0.001) compared with the non-BGC group (n=126). The BGC group had higher rates of modified Rankin Scale (mRS) 0-1 (42.9% vs 27.1%; IPTW aOR 2.78, 95% CI (1.10 to 7.07), P=0.031), mRS 0-2 (60.3% vs 41.5%; IPTW aOR 4.31, 95% CI (1.66 to 11.19), P=0.003), and lower rates of mortality at 90-days (12.7% vs 25.4%; IPTW aOR 0.32, 95% CI (0.11 to 0.98), P=0.047) compared with the non-BGC group. The rates of successful reperfusion at the end of the procedure and symptomatic intracerebral hemorrhage were comparable between both groups.
The present study suggests that the use of BGC in DMVO undergoing MT may be associated with improved angiographic and clinical outcomes with no safety concerns. Prospective studies are warranted.
Details
- Title: Subtitle
- Balloon guide catheter impact on angiographic and clinical outcomes in distal medium vessel occlusion stroke thrombectomy
- Creators
- Mahmoud H Mohammaden - Department of Neurology, South Valley University Faculty of Medicine, Qena, EgyptMohamed F Doheim - University of Pittsburgh School of MedicineJaydevsinh Dolia - Emory University School of MedicineHend Abdelhamid - Emory University School of MedicineStavros Matsoukas - Icahn School of Medicine at Mount SinaiBraxton Riley Schuldt - Icahn School of Medicine at Mount SinaiJohanna T Fifi - Icahn School of Medicine at Mount SinaiOkkes Kuybu - Department of Neurology, Neurosurgery, UPMC, Pittsburgh, Pennsylvania, USAAlhamza R Al-Bayati - Department of Neurology, Neurosurgery, UPMC, Pittsburgh, Pennsylvania, USAMarta Olive Gadea - Hebron UniversityMarc Rodrigo-Gisbert - Hebron UniversityManuel Requena - Hebron UniversityAndre Monteiro - University at Buffalo, State University of New YorkAdnan Siddiqui - University at Buffalo, State University of New YorkFelipe Ferreira - Emory University School of MedicineAyman Gamea - Department of Neurology, South Valley University Faculty of Medicine, Qena, EgyptSiyuan Yu - Cooper Medical School of Rowan UniversityJames E Siegler - Cooper University Health CareMilagros Galecio-Castillo - University of IowaLeonardo Cruz-Criollo - University of IowaSantiago Ortega-Gutierrez - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAGustavo M Cortez - Neurosurgery, Lyerly Neurosurgery, Jacksonville, Florida, USARicardo A Hanel - Neurosurgery, Lyerly Neurosurgery, Jacksonville, Florida, USAAmeer E Hassan - The University of Texas Rio Grande ValleyThanh N Nguyen - Boston University School of MedicineMohamad Abdalkader - Boston Medical CenterPiers Klein - Boston University School of MedicineMohamed M Salem - Hospital of the University of PennsylvaniaJan-Karl Burkhardt - Hospital of the University of PennsylvaniaBrian Jankowitz - Hospital of the University of PennsylvaniaMarco Colasurdo - The University of Texas Medical Branch at GalvestonPeter Kan - The University of Texas Medical Branch at GalvestonMuhammad Hafeez - Baylor College of MedicineOmar Tanweer - Baylor College of MedicineSophia Peng - University of Illinois ChicagoJonathan A Grossberg - Emory University School of MedicineAli Alaraj - University of Illinois ChicagoRaul G Nogueira - Department of Neurology, Neurosurgery, UPMC, Pittsburgh, Pennsylvania, USADiogo C Haussen - Emory University School of Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.18(3), pp.639-646
- DOI
- 10.1136/jnis-2025-023138
- PMID
- 40274405
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8486
- eISSN
- 1759-8486
- Publisher
- BMJ PUBLISHING GROUP; LONDON
- Language
- English
- Electronic publication date
- 05/02/2025
- Date published
- 03/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984816017102771
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