Balloon guide catheter effect on first pass and revascularization success.

BackgroundThe benefit of balloon guide catheter (BGC) use in endovascular thrombectomy (EVT) of patients with acute ischemic stroke remains uncertain. This study assessed the influence of BGC use during EVT on first pass (FP) and revascularization (RV) success in a cohort of stroke patients from a multi-hospital health system. MethodsPatients with anterior circulation large vessel occlusion (LVO) undergoing EVT with stent-retriever or aspiration between 2012 and 2018 at three Kaiser Permanente Southern California (KPSC) region hospitals were identified. A chi-squared test compared the relationship of BGC use with the primary outcomes of FP and RV success using a dichotomized thrombolysis in cerebral infarction (TICI) score of 2b or greater. Results218 patients were included. 35 (16%) underwent EVT with BGC. FP success rate did not significantly differ with 37.1% (95% CI 21.5% to 55.1%) FP success in patients that received EVT with BGC and 41.5% (95% CI 34.3% to 49.0%) in patients that received EVT without BGC (p = 0.71). Successful final RV did not significantly differ between the two groups with 85.7% (95% CI 69.7% to 95.2%) final RV success in the EVT with BGC group and 88.5% (95% CI 83.0% to 92.8%) in the EVT without BGC group (p = 0.78). There was no significant difference in FP (p = 0.88) or RV success (p = 0.42) between the BGC (37% FP and 86% RV), non-BGC stent-retriever (42% FP and 92% RV), and aspiration thrombectomy groups (41% FP and 86% RV). ConclusionThere was no observed association between BGC use in EVT of anterior circulation LVO and rates of first pass revascularization or final revascularization.