TY - JOUR
T1 - Impact of balloon guide catheter on technical and clinical outcomes
T2 - A systematic review and meta-Analysis
AU - Brinjikji, Waleed
AU - Starke, Robert M.
AU - Murad, M. Hassan
AU - Fiorella, David
AU - Pereira, Vitor M.
AU - Goyal, Mayank
AU - Kallmes, David F.
N1 - Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.
PY - 2018/4
Y1 - 2018/4
N2 - Background and purpose Flow arrest with balloon guide catheters (BGCs) is becoming increasingly recognized as critical to optimizing patient outcomes for mechanical thrombectomy. We performed a systematic review and meta-Analysis of the literature for studies that compared angiographic and clinical outcomes for patients who underwent mechanical thrombectomy with and without BGCs. Materials and methods In April 2017 a literature search on BGC and mechanical thrombectomy for stroke was performed. All studies included patients treated with and without BGCs using modern techniques (ie, stent retrievers). Using random effects meta-Analysis, we evaluated the following outcomes: first-pass recanalization, Thrombolysis In Cerebral Infarction (TICI) 3 recanalization, TICI 2b/3 recanalization, favorable outcome (modified Rankin Scale (MRS) 0-2), mortality, and mean number of passes and procedure time. Results Five non-randomized studies of 2022 patients were included (1083 BGC group and 939 non-BGC group). Compared with the non-BGC group, patients treated with BGCs had higher odds of first-pass recanalization (OR 2.05, 95% CI 1.65 to 2.55), TICI 3 (OR 2.13, 95% CI 1.43 to 3.17), TICI 2b/3 (OR 1.54, 95% CI 1.21 to 1.97), and MRS 0-2 (OR 1.84, 95% CI 1.52 to 2.22). BGC-Treated patients also had lower odds of mortality (OR 0.52, 95% CI 0.37 to 0.73) compared with non-BGC patients. The mean number of passes was significantly lower for BGC-Treated patients (weighted mean difference â '0.34, 95% CIâ '0.47 to â '0.22). Mean procedure time was also significantly shorter for BGC-Treated patients (weighted mean difference â '7.7 min, 95% CIâ '9.0to â '6.4). Conclusions Non-randomized studies suggest that BGC use during mechanical thrombectomy for acute ischemic stroke is associated with superior clinical and angiographic outcomes. Further randomized trials are needed to confirm the results of this study.
AB - Background and purpose Flow arrest with balloon guide catheters (BGCs) is becoming increasingly recognized as critical to optimizing patient outcomes for mechanical thrombectomy. We performed a systematic review and meta-Analysis of the literature for studies that compared angiographic and clinical outcomes for patients who underwent mechanical thrombectomy with and without BGCs. Materials and methods In April 2017 a literature search on BGC and mechanical thrombectomy for stroke was performed. All studies included patients treated with and without BGCs using modern techniques (ie, stent retrievers). Using random effects meta-Analysis, we evaluated the following outcomes: first-pass recanalization, Thrombolysis In Cerebral Infarction (TICI) 3 recanalization, TICI 2b/3 recanalization, favorable outcome (modified Rankin Scale (MRS) 0-2), mortality, and mean number of passes and procedure time. Results Five non-randomized studies of 2022 patients were included (1083 BGC group and 939 non-BGC group). Compared with the non-BGC group, patients treated with BGCs had higher odds of first-pass recanalization (OR 2.05, 95% CI 1.65 to 2.55), TICI 3 (OR 2.13, 95% CI 1.43 to 3.17), TICI 2b/3 (OR 1.54, 95% CI 1.21 to 1.97), and MRS 0-2 (OR 1.84, 95% CI 1.52 to 2.22). BGC-Treated patients also had lower odds of mortality (OR 0.52, 95% CI 0.37 to 0.73) compared with non-BGC patients. The mean number of passes was significantly lower for BGC-Treated patients (weighted mean difference â '0.34, 95% CIâ '0.47 to â '0.22). Mean procedure time was also significantly shorter for BGC-Treated patients (weighted mean difference â '7.7 min, 95% CIâ '9.0to â '6.4). Conclusions Non-randomized studies suggest that BGC use during mechanical thrombectomy for acute ischemic stroke is associated with superior clinical and angiographic outcomes. Further randomized trials are needed to confirm the results of this study.
KW - mechanical thrombectomy
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85044781951&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044781951&partnerID=8YFLogxK
U2 - 10.1136/neurintsurg-2017-013179
DO - 10.1136/neurintsurg-2017-013179
M3 - Review article
C2 - 28754806
AN - SCOPUS:85044781951
SN - 1759-8478
VL - 10
SP - 335
EP - 339
JO - Journal of neurointerventional surgery
JF - Journal of neurointerventional surgery
IS - 4
ER -