Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy

Thanh N. Nguyen*, Alicia C. Castonguay, Raul G. Nogueira, Diogo C. Haussen, Joey D. English, Sudhakar R. Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J. Binning, Ajit S. Puri, Nirav A. Vora, Ron F. Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G. Abraham, Randall C. Edgell & 11 others M. Asif Taqi, Ramy El Khoury, Maxim Mokin, Aniel Q. Majjhoo, Mouhammed R. Kabbani, Michael T. Froehler, Ira Finch, Sameer Ahmad Ansari, Roberta Novakovic, Mohamad Abdalkader, Osama O. Zaidat

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Introduction: The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter. Methods: The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. BGC use was at the discretion of the physician. Results: 536 anterior circulation patients (of whom 279 (52.1%) had BGC placement) were included in this analysis. Baseline characteristics were notable for younger patients in the BGC group (65.4±15.3 vs 68.1±13.6, P=0.03) and lower rate of hypertension (72% vs 79%, P=0.06). Mean time from symptom onset to groin puncture was longer in the BGC group (357 vs 319 min, P=0.06).Thrombolysis in Cerebral Infarction 2b/3 scores were higher in the BGC cohort (84% vs 75.5%, P=0.01). There was no difference in reperfusion time, first pass effect, number of passes, or rescue therapy. Good clinical outcome at 3 months was superior in patients with BGC (57% vs 40%; P=0.0004) with a lower mortality rate (13% vs 23%, P=0.008). Multivariate analysis demonstrated that BGC use was an independent predictor of good clinical outcome (OR 2; 95% CI 1.3 to 3.1, P=0.001). Conclusions: In acute stroke patients presenting with anterior circulation large vessel occlusion, use of a BGC with the Trevo stent retriever resulted in improved reperfusion, improved clinical outcome, and lower mortality.

Original languageEnglish (US)
JournalJournal of neurointerventional surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Thrombectomy
Reperfusion
Catheters
Stents
Registries
Stroke
Mortality
Groin
Cerebral Infarction
Punctures
Multivariate Analysis

Keywords

  • balloon
  • catheter
  • stroke
  • technique
  • thrombectomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Nguyen, T. N., Castonguay, A. C., Nogueira, R. G., Haussen, D. C., English, J. D., Satti, S. R., ... Zaidat, O. O. (2019). Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy. Journal of neurointerventional surgery. https://doi.org/10.1136/neurintsurg-2018-014452
Nguyen, Thanh N. ; Castonguay, Alicia C. ; Nogueira, Raul G. ; Haussen, Diogo C. ; English, Joey D. ; Satti, Sudhakar R. ; Chen, Jennifer ; Farid, Hamed ; Borders, Candace ; Veznedaroglu, Erol ; Binning, Mandy J. ; Puri, Ajit S. ; Vora, Nirav A. ; Budzik, Ron F. ; Dabus, Guilherme ; Linfante, Italo ; Janardhan, Vallabh ; Alshekhlee, Amer ; Abraham, Michael G. ; Edgell, Randall C. ; Taqi, M. Asif ; El Khoury, Ramy ; Mokin, Maxim ; Majjhoo, Aniel Q. ; Kabbani, Mouhammed R. ; Froehler, Michael T. ; Finch, Ira ; Ansari, Sameer Ahmad ; Novakovic, Roberta ; Abdalkader, Mohamad ; Zaidat, Osama O. / Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy. In: Journal of neurointerventional surgery. 2019.
@article{8e208787666a473b9444cba02adf6f74,
title = "Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy",
abstract = "Introduction: The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter. Methods: The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. BGC use was at the discretion of the physician. Results: 536 anterior circulation patients (of whom 279 (52.1{\%}) had BGC placement) were included in this analysis. Baseline characteristics were notable for younger patients in the BGC group (65.4±15.3 vs 68.1±13.6, P=0.03) and lower rate of hypertension (72{\%} vs 79{\%}, P=0.06). Mean time from symptom onset to groin puncture was longer in the BGC group (357 vs 319 min, P=0.06).Thrombolysis in Cerebral Infarction 2b/3 scores were higher in the BGC cohort (84{\%} vs 75.5{\%}, P=0.01). There was no difference in reperfusion time, first pass effect, number of passes, or rescue therapy. Good clinical outcome at 3 months was superior in patients with BGC (57{\%} vs 40{\%}; P=0.0004) with a lower mortality rate (13{\%} vs 23{\%}, P=0.008). Multivariate analysis demonstrated that BGC use was an independent predictor of good clinical outcome (OR 2; 95{\%} CI 1.3 to 3.1, P=0.001). Conclusions: In acute stroke patients presenting with anterior circulation large vessel occlusion, use of a BGC with the Trevo stent retriever resulted in improved reperfusion, improved clinical outcome, and lower mortality.",
keywords = "balloon, catheter, stroke, technique, thrombectomy",
author = "Nguyen, {Thanh N.} and Castonguay, {Alicia C.} and Nogueira, {Raul G.} and Haussen, {Diogo C.} and English, {Joey D.} and Satti, {Sudhakar R.} and Jennifer Chen and Hamed Farid and Candace Borders and Erol Veznedaroglu and Binning, {Mandy J.} and Puri, {Ajit S.} and Vora, {Nirav A.} and Budzik, {Ron F.} and Guilherme Dabus and Italo Linfante and Vallabh Janardhan and Amer Alshekhlee and Abraham, {Michael G.} and Edgell, {Randall C.} and Taqi, {M. Asif} and {El Khoury}, Ramy and Maxim Mokin and Majjhoo, {Aniel Q.} and Kabbani, {Mouhammed R.} and Froehler, {Michael T.} and Ira Finch and Ansari, {Sameer Ahmad} and Roberta Novakovic and Mohamad Abdalkader and Zaidat, {Osama O.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1136/neurintsurg-2018-014452",
language = "English (US)",
journal = "Journal of NeuroInterventional Surgery",
issn = "1759-8478",
publisher = "BMJ Publishing Group",

}

Nguyen, TN, Castonguay, AC, Nogueira, RG, Haussen, DC, English, JD, Satti, SR, Chen, J, Farid, H, Borders, C, Veznedaroglu, E, Binning, MJ, Puri, AS, Vora, NA, Budzik, RF, Dabus, G, Linfante, I, Janardhan, V, Alshekhlee, A, Abraham, MG, Edgell, RC, Taqi, MA, El Khoury, R, Mokin, M, Majjhoo, AQ, Kabbani, MR, Froehler, MT, Finch, I, Ansari, SA, Novakovic, R, Abdalkader, M & Zaidat, OO 2019, 'Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy', Journal of neurointerventional surgery. https://doi.org/10.1136/neurintsurg-2018-014452

Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy. / Nguyen, Thanh N.; Castonguay, Alicia C.; Nogueira, Raul G.; Haussen, Diogo C.; English, Joey D.; Satti, Sudhakar R.; Chen, Jennifer; Farid, Hamed; Borders, Candace; Veznedaroglu, Erol; Binning, Mandy J.; Puri, Ajit S.; Vora, Nirav A.; Budzik, Ron F.; Dabus, Guilherme; Linfante, Italo; Janardhan, Vallabh; Alshekhlee, Amer; Abraham, Michael G.; Edgell, Randall C.; Taqi, M. Asif; El Khoury, Ramy; Mokin, Maxim; Majjhoo, Aniel Q.; Kabbani, Mouhammed R.; Froehler, Michael T.; Finch, Ira; Ansari, Sameer Ahmad; Novakovic, Roberta; Abdalkader, Mohamad; Zaidat, Osama O.

In: Journal of neurointerventional surgery, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy

AU - Nguyen, Thanh N.

AU - Castonguay, Alicia C.

AU - Nogueira, Raul G.

AU - Haussen, Diogo C.

AU - English, Joey D.

AU - Satti, Sudhakar R.

AU - Chen, Jennifer

AU - Farid, Hamed

AU - Borders, Candace

AU - Veznedaroglu, Erol

AU - Binning, Mandy J.

AU - Puri, Ajit S.

AU - Vora, Nirav A.

AU - Budzik, Ron F.

AU - Dabus, Guilherme

AU - Linfante, Italo

AU - Janardhan, Vallabh

AU - Alshekhlee, Amer

AU - Abraham, Michael G.

AU - Edgell, Randall C.

AU - Taqi, M. Asif

AU - El Khoury, Ramy

AU - Mokin, Maxim

AU - Majjhoo, Aniel Q.

AU - Kabbani, Mouhammed R.

AU - Froehler, Michael T.

AU - Finch, Ira

AU - Ansari, Sameer Ahmad

AU - Novakovic, Roberta

AU - Abdalkader, Mohamad

AU - Zaidat, Osama O.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter. Methods: The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. BGC use was at the discretion of the physician. Results: 536 anterior circulation patients (of whom 279 (52.1%) had BGC placement) were included in this analysis. Baseline characteristics were notable for younger patients in the BGC group (65.4±15.3 vs 68.1±13.6, P=0.03) and lower rate of hypertension (72% vs 79%, P=0.06). Mean time from symptom onset to groin puncture was longer in the BGC group (357 vs 319 min, P=0.06).Thrombolysis in Cerebral Infarction 2b/3 scores were higher in the BGC cohort (84% vs 75.5%, P=0.01). There was no difference in reperfusion time, first pass effect, number of passes, or rescue therapy. Good clinical outcome at 3 months was superior in patients with BGC (57% vs 40%; P=0.0004) with a lower mortality rate (13% vs 23%, P=0.008). Multivariate analysis demonstrated that BGC use was an independent predictor of good clinical outcome (OR 2; 95% CI 1.3 to 3.1, P=0.001). Conclusions: In acute stroke patients presenting with anterior circulation large vessel occlusion, use of a BGC with the Trevo stent retriever resulted in improved reperfusion, improved clinical outcome, and lower mortality.

AB - Introduction: The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter. Methods: The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. BGC use was at the discretion of the physician. Results: 536 anterior circulation patients (of whom 279 (52.1%) had BGC placement) were included in this analysis. Baseline characteristics were notable for younger patients in the BGC group (65.4±15.3 vs 68.1±13.6, P=0.03) and lower rate of hypertension (72% vs 79%, P=0.06). Mean time from symptom onset to groin puncture was longer in the BGC group (357 vs 319 min, P=0.06).Thrombolysis in Cerebral Infarction 2b/3 scores were higher in the BGC cohort (84% vs 75.5%, P=0.01). There was no difference in reperfusion time, first pass effect, number of passes, or rescue therapy. Good clinical outcome at 3 months was superior in patients with BGC (57% vs 40%; P=0.0004) with a lower mortality rate (13% vs 23%, P=0.008). Multivariate analysis demonstrated that BGC use was an independent predictor of good clinical outcome (OR 2; 95% CI 1.3 to 3.1, P=0.001). Conclusions: In acute stroke patients presenting with anterior circulation large vessel occlusion, use of a BGC with the Trevo stent retriever resulted in improved reperfusion, improved clinical outcome, and lower mortality.

KW - balloon

KW - catheter

KW - stroke

KW - technique

KW - thrombectomy

UR - http://www.scopus.com/inward/record.url?scp=85061097432&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061097432&partnerID=8YFLogxK

U2 - 10.1136/neurintsurg-2018-014452

DO - 10.1136/neurintsurg-2018-014452

M3 - Article

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

ER -