PMID- 31542275 OWN - NLM STAT- MEDLINE DCOM- 20200302 LR - 20200302 IS - 1535-7732 (Electronic) IS - 1051-0443 (Linking) VI - 30 IP - 11 DP - 2019 Nov TI - Balloon Guide Catheter in Endovascular Treatment for Acute Ischemic Stroke: Results from the MR CLEAN Registry. PG - 1759-1764.e6 LID - S1051-0443(19)30544-5 [pii] LID - 10.1016/j.jvir.2019.05.032 [doi] AB - PURPOSE: To 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 METHODS: Data 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. RESULTS: A 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). CONCLUSIONS: In 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. CI - Copyright © 2019 SIR. All rights reserved. FAU - Goldhoorn, Robert-Jan B AU - Goldhoorn RB AD - 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. FAU - Duijsters, Nele AU - Duijsters N AD - Department of Neurology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Room 4.R1.032, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. FAU - Majoie, Charles B L M AU - Majoie CBLM AD - Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands. FAU - Roos, Yvo B W E M AU - Roos YBWEM AD - Department of Neurology, Amsterdam University Medical Center, Amsterdam, The Netherlands. FAU - Dippel, Diederik W J AU - Dippel DWJ AD - Department of Neurology, Erasmus University Medical Center, University Medical Center, Rotterdam, The Netherlands. FAU - van Es, Adriaan C G M AU - van Es ACGM AD - Department of Radiology, Erasmus University Medical Center, University Medical Center, Rotterdam, The Netherlands. FAU - Vos, Jan Albert AU - Vos JA AD - Department of Radiology, Sint Antonius Hospital, Nieuwegein, The Netherlands. FAU - Boiten, Jelis AU - Boiten J AD - Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands. FAU - van Oostenbrugge, Robert J AU - van Oostenbrugge RJ AD - Department of Neurology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Room 4.R1.032, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. FAU - van Zwam, Wim H AU - van Zwam WH AD - Department of Radiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Room 4.R1.032, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. CN - MR CLEAN Registry Investigators LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20190918 PL - United States TA - J Vasc Interv Radiol JT - Journal of vascular and interventional radiology : JVIR JID - 9203369 SB - IM MH - Aged MH - Aged, 80 and over MH - Brain Ischemia/diagnostic imaging/physiopathology/*therapy MH - Cerebrovascular Circulation MH - Disability Evaluation MH - Endovascular Procedures/adverse effects/*instrumentation MH - Female MH - Humans MH - Male MH - Middle Aged MH - Netherlands MH - Randomized Controlled Trials as Topic MH - Recovery of Function MH - Registries MH - Stents MH - Stroke/diagnostic imaging/physiopathology/*therapy MH - Thrombectomy/adverse effects/*instrumentation MH - Time Factors MH - Treatment Outcome MH - *Vascular Access Devices EDAT- 2019/09/23 06:00 MHDA- 2020/03/03 06:00 CRDT- 2019/09/23 06:00 PHST- 2019/02/27 00:00 [received] PHST- 2019/05/27 00:00 [revised] PHST- 2019/05/31 00:00 [accepted] PHST- 2019/09/23 06:00 [pubmed] PHST- 2020/03/03 06:00 [medline] PHST- 2019/09/23 06:00 [entrez] AID - S1051-0443(19)30544-5 [pii] AID - 10.1016/j.jvir.2019.05.032 [doi] PST - ppublish SO - J Vasc Interv Radiol. 2019 Nov;30(11):1759-1764.e6. doi: 10.1016/j.jvir.2019.05.032. Epub 2019 Sep 18.