Balloon guide catheter impact on angiographic and clinical outcomes in distal medium vessel occlusion stroke thrombectomy.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Mohammaden Mahmoud H, Doheim Mohamed F, Dolia Jaydevsinh, Abdelhamid Hend, Matsoukas Stavros, Schuldt Braxton Riley, Fifi Johanna T, Kuybu Okkes, Al-Bayati Alhamza R, Olive Gadea Marta, Rodrigo-Gisbert Marc, Requena Manuel, Monteiro Andre, Siddiqui Adnan, Ferreira Felipe, Gamea Ayman, Yu Siyuan, Siegler James E, Galecio-Castillo Milagros, Cruz-Criollo Leonardo, Ortega-Gutierrez Santiago, Cortez Gustavo M, Hanel Ricardo A, Hassan Ameer E, Nguyen Thanh N, Abdalkader Mohamad, Klein Piers, Salem Mohamed M, Burkhardt Jan-Karl, Jankowitz Brian, Colasurdo Marco, Kan Peter, Hafeez Muhammad, Tanweer Omar, Peng Sophia, Grossberg Jonathan A, Alaraj Ali, Nogueira Raul G, Haussen Diogo C
Аннотация
METHODS: This is a retrospective analysis of a prospectively collected database from 14 comprehensive stroke centers in the United States and Europe. Patients with anterior circulation DMVO due to middle cerebral artery (MCA) M3/M4 or anterior cerebral artery (ACA) A1/A2-3 were included. The cohort was divided into BGC and non-BGC groups. Multivariable logistic regression and inverse probability of treatment weighting (IPTW) were used for comparison. The primary outcome was first pass effect (FPE) defined as modified treatment in cerebral infarction (mTICI) grade 2C/3 after single device pass.
RESULTS: Among 199 patients who were eligible for analysis, 81 (40.7%) were female. The median age was 69 (60-81) years, and National Institutes of Health Stroke Scale score was 13 (7-18). The BGC group (n=73) had higher rates of FPE (53.4% vs 13.7%; IPTW aOR 5.63, 95%CI (2.43 to 13.10), P<0.001) compared with the non-BGC group (n=126). The BGC group had higher rates of modified Rankin Scale (mRS) 0-1 (42.9% vs 27.1%; IPTW aOR 2.78, 95% CI (1.10 to 7.07), P=0.031), mRS 0-2 (60.3% vs 41.5%; IPTW aOR 4.31, 95% CI (1.66 to 11.19), P=0.003), and lower rates of mortality at 90-days (12.7% vs 25.4%; IPTW aOR 0.32, 95% CI (0.11 to 0.98), P=0.047) compared with the non-BGC group. The rates of successful reperfusion at the end of the procedure and symptomatic intracerebral hemorrhage were comparable between both groups.
CONCLUSION: The present study suggests that the use of BGC in DMVO undergoing MT may be associated with improved angiographic and clinical outcomes with no safety concerns. Prospective studies are warranted.