Journal article
Impact of Balloon Guide Catheter Use on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry
Stroke (1970), Vol.50(3), pp.STROKEAHA118021126-704
02/19/2019
DOI: 10.1161/STROKEAHA.118.021126
PMID: 30776994
Abstract
Background and Purpose- Mechanical thrombectomy has been shown to improve clinical outcomes in patients with acute ischemic stroke. However, the impact of balloon guide catheter (BGC) use is not well established. Methods- STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter study of patients with large vessel occlusion treated with the Solitaire stent retriever as first-line therapy. In this study, an independent core laboratory, blinded to the clinical outcomes, reviewed all procedures and angiographic data to classify procedural technique, target clot location, recanalization after each pass, and determine the number of stent retriever passes. The primary clinical end point was functional independence (modified Rankin Scale, 0-2) at 3 months as determined on-site, and the angiographic end point was first-pass effect (FPE) success rate from a single device attempt (modified Thrombolysis in Cerebral Infarction, ≥2c) as determined by a core laboratory. Achieving modified FPE (modified Thrombolysis in Cerebral Infarction, ≥2b) was also assessed. Comparisons of clinical outcomes were made between groups and adjusted for baseline and procedural characteristics. All participating centers received institutional review board approval from their respective institutions. Results- Adjunctive technique groups included BGC (n=445), distal access catheter (n=238), and conventional guide catheter (n=62). The BGC group had a higher rate of FPE following first pass (212/443 [48%]) versus conventional guide catheter (16/62 [26%]; P=0.001) and distal access catheter (83/235 [35%]; P=0.002). Similarly, the BGC group had a higher rate of modified FPE (294/443 [66%]) versus conventional guide catheter (26/62 [42%]; P<0.001) and distal access catheter (129/234 [55%]; P=0.003). The BGC group achieved the highest rate of functional independence (253/415 [61%]) versus conventional guide catheter (23/55 [42%]; P=0.007) and distal access catheter (113/218 [52%]; P=0.027). Final revascularization and mortality rates did not differ across the groups. Conclusions- BGC use was an independent predictor of FPE, modified FPE, and functional independence, suggesting that its routine use may improve the rates of early revascularization success and good clinical outcomes. Clinical Trial Registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT02239640.
Details
- Title: Subtitle
- Impact of Balloon Guide Catheter Use on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry
- Creators
- Colin P Derdeyn - Barnes Jewish Hospital, St. Louis, MO (C.P.D.)Osama O Zaidat - From the Mercy Health St. Vincent Mercy Hospital, Toledo, OH (O.O.Z.)Nils H Mueller-Kronast - Advanced Neuroscience Network/Tenet South Florida, Coral Springs (N.H.M.-K., R.K.)Ameer E Hassan - Valley Baptist Medical Center, Harlingen, TX (A.E.H.)Diogo C Haussen - Grady Memorial Hospital, Atlanta, GA (D.C.H., R.G.N.)Ashutosh P Jadhav - University of Pittsburgh Medical Center, PA (A.P.J.)Michael T Froehler - Vanderbilt University Medical Center, Nashville, TN (M.T.F., R.C.)Reza Jahan - University of California, Los Angeles, CA (R.J., J.L.S., S.S., D.S.L.)Mohammad Ali Aziz-Sultan - Brigham and Women's Hospital, Boston, MA (M.A.A-S.)Richard P Klucznik - Methodist Hospital, Houston, TX (R.P.K.)Jeffrey L Saver - University of California, Los Angeles, CA (R.J., J.L.S., S.S., D.S.L.)Frank R Hellinger Jr - Florida Hospital Neuroscience Institute, Winter Park (F.R.H., R.H.G.)Dileep R Yavagal - University of Miami Miller School of Medicine/Jackson Memorial Hospital, FL (D.R.Y., E.C.P.)Tom L Yao - Norton Neuroscience Institute, Norton Healthcare, Louisville, KY (T.L.Y., S.D.)Rishi Gupta - WellStar Neurosciences Network, WellStar Kennestone Regional Medical Center, Marietta, GA (R.G.)Coleman O Martin - St. Luke's Hospital of Kansas City, MO (C.O.M.)Hormozd Bozorgchami - Oregon Health and Science University Hospital, Portland (H.B.)Ritesh Kaushal - Advanced Neuroscience Network/Tenet South Florida, Coral Springs (N.H.M.-K., R.K.)Raul G Nogueira - Grady Memorial Hospital, Atlanta, GA (D.C.H., R.G.N.)Ravi H Gandhi - Florida Hospital Neuroscience Institute, Winter Park (F.R.H., R.H.G.)Eric C Peterson - University of Miami Miller School of Medicine/Jackson Memorial Hospital, FL (D.R.Y., E.C.P.)Shervin Dashti - Norton Neuroscience Institute, Norton Healthcare, Louisville, KY (T.L.Y., S.D.)Curtis A Given II - Baptist Health Lexington/Central Baptist, KY (C.A.G.)Brijesh P Mehta - South Broward Hospital, Hollywood, FL (B.P.M.)Vivek Deshmukh - Providence St. Vincent Medical Center, Portland, OR (V.D.)Sidney Starkman - University of California, Los Angeles, CA (R.J., J.L.S., S.S., D.S.L.)Italo Linfante - Baptist Hospital of Miami, FL (I.L.)Scott H McPherson - St. Dominic's-Jackson Memorial Hospital, MS (S.H.M.)Peter Kvamme - University of Tennessee Medical Center, Knoxville (P.K.)Thomas J Grobelny - Advocate Christ Medical Center, Oak Lawn, IL (T.J.G.)Muhammad Shazam Hussain - Cleveland Clinic, OH (M.S.H.)Ike Thacker - Baylor University Medical Center, Dallas, TX (I.T.)Nirav Vora - Ohio Health Riverside Methodist Hospital, Columbus (N.V.)Peng Roc Chen - Memorial Hermann Texas Medical Center, Houston (P.R.C.)Stephen J Monteith - Swedish Medical Center First Hill Campus, Seattle, WA (S.J.M.)Robert D Ecker - Maine Medical Center, Portland, ME (R.D.E.)Clemens M Schirmer - Geisinger Clinic, Danville, PA (C.M.S.)Eric Sauvageau - Baptist Medical Center Jacksonville, FL (E.S.)Alex Bou Chebl - Baptist Hospital Louisville, KY (A.B.C.)Lucian Maidan - Mercy San Juan Medical Center and Mercy General, Carmichael, CA (L.M.)Aamir Badruddin - Presence St. Joseph Medical Center, Joliet, IL (A.B.)Adnan H Siddiqui - Buffalo General Medical Center, NY (A.H.S.)Travis M Dumont - University of Arizona Medical Center, Tucson (T.M.D.)Abdulnasser Alhajeri - University of Kentucky Hospital, Lexington (A.A.)Muhammad A Taqi - Los Robles Medical Center, Thousand Oaks, CA (M.A.T.)Khaled Asi - Aurora Hospital, Milwaukee, WI (K.A.)Jeffrey Carpenter - West Virginia University/Ruby Memorial Hospital, Morgantown (J.C.)Alan Boulos - Albany Medical Center, NY (A.B.)Gaurav Jindal - University of Maryland Medical Center, Baltimore (G.J.)Ajit S Puri - University of Massachusetts Memorial Medical Center, Worcester (A.S.P.)Rohan Chitale - Vanderbilt University Medical Center, Nashville, TN (M.T.F., R.C.)Eric M Deshaies - Crouse Hospital, Syracuse, NY (E.M.D.)David Robinson - Virginia Mason Medical Center, Seattle, WA (D.R.)David F Kallmes - Mayo Clinic, Rochester, MN (D.F.K.)Blaise W Baxter - Erlanger Medical Center, Chattanooga, TN (B.W.B.)Mouhammed Jumaa - ProMedica Toledo Hospital, OH (M.J.)Peter Sunenshine - Banner University Medical Center, Phoenix, AZ (P.S.)Aniel Majjhoo - McLaren Flint, MI (A.M.)Joey D English - California Pacific Medical Center, San Francisco (J.D.E.)Shuichi Suzuki - University of California, Irvine (S.S.)Richard D Fessler - St. John Providence Hospital, Detroit, MI (R.D.F.)Josser Delgado-Almandoz - Abbott Northwestern Hospital, Minneapolis, MN (J.D-A.)Jerry C Martin - Carolinas Medical Center, Charlotte, NC (J.C.M.)David S Liebeskind - University of California, Los Angeles, CA (R.J., J.L.S., S.S., D.S.L.)
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.50(3), pp.STROKEAHA118021126-704
- DOI
- 10.1161/STROKEAHA.118.021126
- PMID
- 30776994
- NLM abbreviation
- Stroke
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- United States
- Language
- English
- Date published
- 02/19/2019
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984070231302771
Metrics
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