Journal of Korean Neurosurgical Society

  • 제60권2호
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  • Pages.155-164
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  • 2017
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

  • Oh, Jae-Sang (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Yoon, Seok-Mann (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Shim, Jai-Joon (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Doh, Jae-Won (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Bae, Hack-Gun (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Lee, Kyeong-Seok (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
  • 투고 : 2016.09.26
  • 심사 : 2016.12.09
  • 발행 : 2017.03.01
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초록

Objective : To evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke. Methods : Sixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated. Results : Successful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19 : 95% confidence interval, 1.07-25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01). Conclusion : A BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.

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참고문헌

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  2. Anterior cerebral artery embolism during thrombectomy increases disability and mortality vol.10, pp.11, 2018, https://doi.org/10.1136/neurintsurg-2018-013793
  3. Experience of the New FlowGate2 Device as a Balloon Guide Catheter for Ischemic Stroke Intervention vol.126, pp.None, 2019, https://doi.org/10.1016/j.wneu.2019.02.140
  4. The Effects of Balloon-Guide Catheters on Outcomes after Mechanical Thrombectomy in Acute Ischemic Strokes : A Meta-Analysis vol.62, pp.4, 2017, https://doi.org/10.3340/jkns.2018.0165
  5. Efficacy of Combining Proximal Balloon Guiding Catheter and Distal Access Catheter in Thrombectomy with Stent Retriever for Anterior Circulation Ischemic Stroke vol.62, pp.4, 2017, https://doi.org/10.3340/jkns.2019.0007
  6. Clinical and Procedural Outcomes with or without Balloon Guide Catheters during Endovascular Thrombectomy in Acute Ischemic Stroke: A Systematic Review and Meta-analysis with First-line Technique Subg vol.42, pp.8, 2017, https://doi.org/10.3174/ajnr.a7164
  7. Balloon guide catheter improvements in thrombectomy outcomes persist despite advances in intracranial aspiration technology vol.13, pp.9, 2017, https://doi.org/10.1136/neurintsurg-2020-017027
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