• Robert-Jan B Goldhoorn, Nele Duijsters, MajoieCharles B L MCBLMDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands., RoosYvo B W E MYBWEMDepartment of Neurology, Amsterdam University Medical Center, Amsterdam, The Netherlands., DippelDiederik W JDWJDepartment of Neurology, Erasmus University Medical Center, University Medical Center, Rotterdam, The Netherlands., Adriaan C G M van Es, Jan Albert Vos, Jelis Boiten, Robert J van Oostenbrugge, Wim H van Zwam, and MR CLEAN Registry Investigators.
• Department of Neurology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Room 4.R1.032, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. Electronic address: robertjan.goldhoorn@mumc.nl.
• J Vasc Interv Radiol. 2019 Nov 1; 30 (11): 1759-1764.e6.

PurposeTo compare outcomes after endovascular treatment (EVT) for acute ischemic stroke with and without the use of a balloon guide catheter (BGC) in clinical practice.Materials And MethodsData from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry were used, in which all patients who underwent EVT for anterior-circulation stroke in The Netherlands between 2014 and 2016 were enrolled. Primary outcome was modified Rankin scale (mRS) score at 90 days. Secondary outcomes included reperfusion grade (extended Thrombolysis In Cerebral Infarction [eTICI] score) and National Institutes of Health Stroke Scale (NIHSS) score 24-48 hours after intervention. The association between the use of a BGC and outcomes was estimated with logistic regression adjusted for age, sex, prestroke mRS score, NIHSS score, collateral grade, and time from onset to EVT.ResultsA total of 887 patients were included. Thrombectomy was performed with the use of a BGC in 528 patients (60%) and without in 359 patients (40%). There was no significant association between use of a BGC and a shift on the mRS toward better outcome (adjusted common odds ratio, 1.17; 95% confidence interval [CI], 0.91-1.52). Use of a BGC was associated with higher eTICI score (adjusted common OR, 1.33; 95% CI, 1.04-1.70) and improvement of ≥ 4 points on the NIHSS (adjusted OR, 1.40; 95% CI, 1.04-1.88).ConclusionsIn clinical practice, use of a BGC was associated with higher reperfusion grade and early improvement of neurologic deficits, but had no positive effect on long-term functional outcome.Copyright © 2019 SIR. All rights reserved.

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