Background and purpose Mechanical thrombectomy (MT) with proximal flow control and negative aspiration may improve the outcome of endovascular revascularization therapy (ERT) for acute stroke patients. The purpose of this study is to compare the impact of balloon guide catheter (BGC) catheterization in patients treated for anterior circulation acute ischemic stroke using mechanical thrombectomy.

Method The influences of the BGC catheterization position (proximal; placement of BGC proximal to atlas vertebral body (C2,C3,C4), distal; Placement of BGC is the skull base or upper side of atlas vertebral body lower margin) was analyzed in acute stroke patients with large anterior circulation occlusion. The baseline clinical characteristics, procedural variables, recanalization rate and clinical outcomes were compared.

Result The clinical analysis included 102 patients (age: 70.1±12.3 70). The locations of the BGC inflations were distal (n=49) and proximal (n=53) groups. The recanalization rate was significantly higher in the distal BGC group (98.0% versus 71.7%; p<0.001). Needle to recanalization time was shorter in the distal balloon group than the proximal balloon group (40 (27–61) vs 55.5 (28–86.5) p=0.076). The incidence of emboli to new territory (ENT) and Distal emboli were less frequent in the distal BGC group.

Conclusions Catheterization of the BGC may have impact on the recanalization of occluded anterior circulation arteries in acute stroke patients. The BGC should be catheterized as distally as possible in the cervical ICA for maximally effective thrombectomy.

Disclosures D. Jeong: None. D. Kim: None.