TY - JOUR T1 - Balloon guide catheter improvements in thrombectomy outcomes persist despite advances in intracranial aspiration technology JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 773 LP - 778 DO - 10.1136/neurintsurg-2020-017027 VL - 13 IS - 9 AU - Jordi Blasco AU - Josep Puig AU - Pepus Daunis-i-Estadella AU - Eva González AU - Juan Jose Fondevila Monso AU - Xabier Manso AU - Rafael Oteros AU - Elvira Jimenez-Gomez AU - Isabel Bravo Rey AU - Pedro Vega AU - Eduardo Murias AU - Jose Maria Jimenez AU - Antonio López-Rueda AU - Arturo Renú AU - Sonia Aixut AU - Oscar Chirife Chaparro AU - Santiago Rosati AU - Manuel Moreu AU - Sebastian Remollo AU - Yeray Aguilar Tejedor AU - Mikel Terceño AU - Antonio Mosqueira AU - Raul G Nogueira AU - Luis San Roman Y1 - 2021/09/01 UR - http://jnis.bmj.com/content/13/9/773.abstract N2 - Background First-pass effect (FPE) has been established as a key metric for technical success and strongly correlates with better clinical outcomes. Most data supporting improved outcomes with the use of a balloon guide catheter (BGC) predate the advent of last-generation large-bore intracranial aspiration catheters. We aim to evaluate the impact of BGC in FPE and clinical outcomes in a large cohort of patients treated with contemporary technology.Methods Patients were recruited from the prospectively ongoing ROSSETTI registry. This registry includes all consecutive patients with anterior circulation large-vessel occlusion (LVO) from 10 comprehensive stroke centers in Spain. Demographic, clinical, angiographic, and clinical outcome data were compared between BGC and non-BGC groups. FPE was defined as the achievement of mTICI2c–3 after a single device pass.Results 426 patients were included out of which 271 (63.62%) used BCG. BGC-treated patients had higher FPE rate (45.8% vs 27.7%; P<0.001), higher final mTICI ≥2 c recanalization rate (76.8% vs 50.3%, respectively; P<0.001), shorter procedural time [median (IQR), 30 (19–58) vs 43 (33–71) min; P<0.001], higher NIHSS difference from admission to 24 hours [median (IQR), 8 (2–12) vs 3 (0–10); P=0.001], and lower mortality rate (17.6% vs 29.8%, P=0.026) compared with non-BGC patients. BGC use was an independent predictor of FPE (OR 2.197, 95% CI 1.436 to 3.361; P<0.001), and excellent clinical outcome at 3 months (OR 0.34, 95% CI 0.17 to 0.68; P=0.002).Conclusions Our results support the benefit of BGC use on angiographic and clinical outcomes in anterior circulation LVO ischemic stroke remain significant even when considering recent improvements in intracranial aspiration technology. ER -