Abstract TP28: Influence of Ballon Guide Catheter Cathterization on Mechanical Thrombectomy in Acute Stroke Patients

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Background and purpose: Mechanical thrombectomy (MT) with proximal flow control and negative aspiration may improve the outcome of endovascular revascularization therapy (ERT) for acute stroke patients. The purpose of this study is to compare the effects of balloon guide catheter (BGC) catheterization on benchtop tests and in patients treated for anterior circulation acute ischemic stroke using mechanical thrombectomy.Method: A benchtop test was performed with a silicone cerebrovascular model. The negative suction pressure was compared according to the catheterization location {proximal; placement of BGC proximal to atlas vertebral body(2nd, 3rd and 4th cervical vertabra) , distal; Placement of BGC is the skull base or upper side of atlas vertebral body lower margin}of the BGC. The influences of the BGC was analyzed in acute stroke patients with large anterior circulation occlusion. The baseline clinical characteristics, procedural variables, recanalization rate and clinical outcomes were compared.Result: The benchtop test showed that the distally located balloon showed 11 % increase in suction pressure. The clinical analysis included 104 patients (age: 70.1±12.3 70). The locations of the BGC inflations were distal (n=47) and proximal (n=57) groups. Proximal BGC group was more frequently associated with hypertension (77% versus 57%; P=0.031). The recanalization rate was significantly higher in the distal BGC group (95.7% versus 66.7%; P<0.0001). Needle to recanalization time is more shorter in distal balloon group than proximal balloon group (48.57 ± 26.1 VS 68.3 ± 44.8 P = 0.005). The incidence of emboli to new territory (ENT) was less frequent in the distal BGC group.Conclusions: Catheterization of the BGC may have influences on the recanalization of occluded anterior circulation arteries in acute stroke patients. The BGC should be navigated as distally as possible in the cervical ICA for maximally effective thrombectomy.

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