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We read with interest the meta-analysis conducted by our colleague Dr Waleed Brinjikji (1). In the text (section "Limitations", he stated: "Data from the Interest of Direct Aspiration First Pass Technique (ADAPT) for Thrombectomy Revascularization of Large Vessel Occlusion in Acute Ischemic Stroke (ASTER) trial suggest that there were no statistically significant differences in revascularization rates when performing the ADAPT technique compared with using a stent retriever. However, it is unclear at this time whether BGCs were used in this trial."
Nevertheless in our publication of the ASTER trial results (2), we clearly stated in the Results section that a balloon-guide catheter was used to allow proximal flow arrest during stent retriever removal in 92% of patients treated with the stent retriever technique.
1. Brinjikji W, Starke RM, Murad MH, et al. Impact of balloon guide catheter on technical and clinical outcomes: a systematic review and meta-analysis. J Neurointerv Surg 2018;10:335–339.
2. Lapergue B, Blanc R, Gory B, et al. JAMA. 2017;318:443-452.