scholarly journals Balloon Guide Catheter Is Beneficial in Endovascular Treatment Regardless of Mechanical Recanalization Modality

Stroke ◽  
2019 ◽  
Vol 50 (6) ◽  
pp. 1490-1496 ◽  
Author(s):  
Jang-Hyun Baek ◽  
Byung Moon Kim ◽  
Dong-Hun Kang ◽  
Ji Hoe Heo ◽  
Hyo Suk Nam ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Mechanical Recanalization ◽  
Guide Catheter

Balloon Guide Catheter in Endovascular Treatment for Acute Ischemic Stroke: Results from the MR CLEAN Registry

2019 ◽  
Vol 30 (11) ◽  
pp. 1759-1764.e6 ◽  
Author(s):  
Robert-Jan B. Goldhoorn ◽  
Nele Duijsters ◽  
Charles B.L.M. Majoie ◽  
Yvo B.W.E.M. Roos ◽  
Diederik W.J. Dippel ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Guide Catheter ◽  
Mr Clean

scholarly journals Intracranial Mechanical Recanalization and Fibrinolysis Using a Single Hyperglide Balloon Microcatheter

2005 ◽  
Vol 11 (3) ◽  
pp. 277-280
Author(s):  
E. Castro Reyes ◽  
F. Fortea Gil ◽  
F. Villoria Medina ◽  
J. Guzmán De Villoria ◽  
L. Muñoz Almazán ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Procedure Time ◽  
Mechanical Recanalization

Endovascular treatment of acute blockage of the middle cerebral artery may require a combination of mechanical recanalization and chemical fibrinolysis. Using a single microcatheter to perform both techniques helps shorten procedure time.

Balloon Guide Catheter is Not Superior to Conventional Guide Catheter when Stent Retriever and Contact Aspiration are Combined for Stroke Treatment

Neurosurgery ◽  
2020 ◽  
Vol 88 (1) ◽  
pp. E83-E90
Author(s):  
Romain Bourcier ◽  
Gaultier Marnat ◽  
Julien Labreuche ◽  
Hubert Desal ◽  
Federico Di Maria ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Clinical Outcomes ◽  
Stent Retriever ◽  
Added Value ◽  
Complete Revascularization ◽  
First Line ◽  
Stroke Treatment ◽  
Guide Catheter ◽  
Significant Difference

Abstract BACKGROUND The effectiveness of balloon guide catheter (BGC) use has not been prospectively studied and its added value for improving reperfusion in acute ischemic stroke (AIS) treatment has only been reported in studies in which no contact aspiration was combined with the stent retriever (CA + SR). OBJECTIVE To compare the reperfusion results and clinical outcomes with and without BGC use when a combined CA + SR strategy is employed in first line to treat AIS. METHODS From January 2016 to April 2019, data from the ETIS registry (Endovascular Treatment in Ischemic Stroke) were reviewed. We included patients having undergone endovascular treatment with a combined CA + SR strategy and use or not of a BGC according to the operator's discretion. We compared BGC and nonBGC populations with matching and inverse probability of treatment weighting propensity scores. Primary outcome was the final near-complete/complete revascularization (mTICI2c/3) rate. Secondary outcomes included clinical outcomes and safety considerations. RESULTS Among 607 included patients, BGC was used in 32.9% (n = 200), and 190 matched pairs could be found. We found no significant difference in final mTICI2c/3 between patients with and without BGC (60.1% in BGC group compared to 62.7% in nonBGC group (matched RR, 0.92; 95%CI, 0.80 to 1.14)), first-pass mTICI2c/3 (35.1% vs 37.3%, matched RR, 0.94; 95%CI, 0.68 to 1.30), clinical outcome (matched RR of 1.12 (95%CI, 0.85 to 1.47) for favorable outcome. CONCLUSION The reperfusion and clinical results with and without BGC use are not significantly different when combined CA + SR are used as a first-line strategy for large vessel occlusion in the setting of AIS.

Nuances of Endovascular Treatment of Transverse/Sigmoid Sinus Stenosis With Stenting Venoplasty in a Patient With Pseudotumor Cerebri: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (3) ◽  
pp. 393-394
Author(s):  
Leonardo Rangel-Castilla ◽  
Adnan H Siddiqui
Keyword(s):  
Endovascular Treatment ◽  
Antiplatelet Therapy ◽  
Venous Pressure ◽  
Pseudotumor Cerebri ◽  
Sigmoid Sinus ◽  
Venous Sinus ◽  
Chronic Obstructive ◽  
Guide Catheter ◽  
Patient Consent ◽  
Sinus Stenosis

Abstract We present a case of a patient with pseudotumor cerebri (PC) and transverse/sigmoid junction sinus (TSJS) stenosis treated with stenting venoplasty. A 54-yr-old man with a history of hypertension, hyperlipidemia, and chronic obstructive pulmonary disease presented with subacute onset of progressive headaches, blurred vision, and papilledema. He was clinically diagnosed with PC. Left TSJS stenosis was suspected on magnetic resonance venography and confirmed with digital subtraction angiography and venography. During angiography, venous pressures were measured along the intracranial venous system revealing a significant drop compared with pressures obtained from the superior sagittal and sigmoid sinuses. For 7 d prior to venous sinus stenting, he was prescribed antiplatelet therapy with aspirin (350 mg/d) and clopidogrel (75 mg/d). Patient consent was obtained prior to performing the procedure; institutional board approval is not required for the report of a single case. Under conscious sedation and systemic heparinization, the patient underwent endovascular stenting of the left TSJS with an open-cell carotid stent (Precise 7 × 40 mm; Cordis, Milpitas, California). Successful left TSJS reconstruction transpired with no procedure-related complications. The patient was discharged home 1 d postprocedure. After 2 mo of dual antiplatelet therapy, clopidogrel was discontinued. At the 1-yr follow-up, he had resolution of papilledema and notably less intense headaches. Venous sinus stenting is an effective endovascular treatment for symptomatic patients with PC and sinus stenosis. Venous pressure measurement is imperative for patient selection. Adequate venous access with a 6-French guide catheter into the sigmoid sinus and an intermediate catheter into the transverse sinus is crucial to navigate a stent through the acute angles of the TSJS and jugular vein.

scholarly journals Endovascular stroke treatment using balloon guide catheters may reduce penumbral tissue damage and improve long-term outcome

2020 ◽  
Author(s):  
Maria T. Berndt ◽  
Mayank Goyal ◽  
Marios Psychogios ◽  
Johannes Kaesmacher ◽  
Tobias Boeckh-Behrens ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Diffusion Tensor ◽  
Ischemic Damage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Mechanical Recanalization ◽  
Guide Catheter ◽  
Microstructural Integrity ◽  
The Impact

Abstract Objectives During mechanical recanalization of large vessel occlusions (LVO), the use of proximal flow arrest with balloon guide catheters (BGC) was shown to be associated with better angiographic and even clinical outcome. The aim of the study was to analyze the impact of BGC use on microstructural alterations in the salvaged penumbra. Methods All patients who underwent mechanical recanalization of LVO of the anterior circulation were reviewed within a prospective stroke registry of a single comprehensive stroke center. Fifty-two patients received an admission CT perfusion together with post-interventional diffusion tensor imaging. Technical details such as BGC usage were correlated with microstructural integrity changes of the salvaged gray matter through the mean diffusivity (MD) index. Moderation analysis was performed to test the interaction of BGC on the correlation between angiographic and clinical outcomes. Results For all patients with complete reperfusion, microstructural integrity changes with lowered MD index were found within the salvaged penumbra for cases of non-BGC usage (mean − 0.02) compared to cases with BGC usage (0.01, p = 0.04). The importance of complete reperfusion for good clinical outcome is predominantly based on patients treated with BGC (effect 2.78, p = 0.01 vs. for non-BGC: 0.3, p = 0.71). Conclusions The lowered MD index early after mechanical recanalization without BGC usage can be interpreted as microstructural ischemic damage of the salvaged penumbra. It was shown that achieving complete reperfusion in a setting of BGC usage with proximal flow arrest minimizes penumbral damage and improves long-term outcomes. Key Points • Microstructural ischemic damage can be reduced by using proximal flow arrest during endovascular treatment with balloon guide catheter. • Complete reperfusion in a setting of balloon guide catheter minimizes penumbral damage and improves long-term outcome.

scholarly journals Retriever first embolectomy (ReFirE): An alternative approach for challenging cervical access

2017 ◽  
Vol 23 (4) ◽  
pp. 412-415 ◽  
Author(s):  
Daniel Behme ◽  
Michael Knauth ◽  
Marios-Nikos Psychogios
Keyword(s):  
Endovascular Treatment ◽  
Standard Of Care ◽  
Artery Occlusion ◽  
Exclusion Criterion ◽  
Large Artery ◽  
Direct Puncture ◽  
First Case ◽  
Guide Catheter ◽  
Number Of Patients ◽  
Diagnostic Catheter

After endovascular treatment became the standard of care procedure for acute ischaemic stroke with large artery occlusion in 2015 the number of performed interventions has increased dramatically. Especially because age is no exclusion criterion for endovascular treatment, a relevant number of patients with difficult to access carotid arteries has to be treated. In these patients a direct puncture of the carotid is a valuable tool but is associated with severe complications and an initial learning curve. We therefore developed the so called retriever first embolectomy (ReFirE) technique in which a stentretriever is deployed over a 5F diagnostic catheter and a microcatheter to establish a stable anchor prior to accessing the internal carotid artery/intracranial vasculature with an 8F guide catheter and a 5F/6F intermediate catheter. We hereby report the first case in which we performed a thrombectomy applying our novel technique.

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