@article {Blasco863, author = {Jordi Blasco and Josep Puig and Antonio L{\'o}pez-Rueda and Pepus Daunis-i-Estadella and Laura Llull and Federico Zarco and Napoleon Macias and Juan Macho and Eva Gonz{\'a}lez and Ion Labayen and Pedro Vega and Eduardo Murias and Elvira Jimenez-Gomez and Isabel Bravo Rey and Manuel Moreu and Carlos P{\'e}rez-Garc{\'\i}a and Oscar Chirife Chaparro and Sonia Aixut and Mikel Terce{\~n}o and Mariano Werner and Jos{\'e} Manuel Pumar and Yeray Aguilar Tejedor and Jose Carlos Mendez and Sarai Moliner and Raul G Nogueira and Luis San Roman}, editor = {, and , and Gonz{\'a}lez D{\'\i}az, E and Azparren, Labayen and Gonz{\'a}lez D{\'\i}az, E and Azparren, Labayen and Fondevila Mons{\'o}, J and Ca{\~n}o, Manso del and Vega, P and Murias, E and Jim{\'e}nez P{\'e}rez, JM and Chaviano Grajera, J and Casta{\~n}on Apilanez, M and Lopez Cancio, E and Oteros Fern{\'a}ndez, R and Jim{\'e}nez-G{\'o}mez, E and Rey, Bravo and Saucedo, Romero and Delgado Acosta, F and San Rom{\'a}n, L and L{\'o}pez-Rueda, A and Macho, J and Mac{\'\i}as, N and Zarco, F and Ren{\'u} Jornet, A and Blasco, J and Moreu, M and Perez-Garc{\'\i}a, C and Rosati, S and L{\'o}pez-Frias, A and Chirife Chaparro, O and Aixut, S and Caama{\~n}o, Rodr{\'\i}guez and Miquel MA, de Miquel and Barranco Pons, R and Aja Rodr{\'\i}guez, L and Camasca, Cuba and Terce{\~n}o, M and Bashir, S and Paul, L and Werner, M and Casta{\~n}o, C and Remollo, S and Pumar, JM and Mosqueira, A and Aguilar Tejedor, Y and Cubillo Prieto, D and Toboada A, Bravo de Laguna and M{\'e}ndez, JC and Berm{\'u}dez-Coronel, I and Fandi{\~n}o, E and Gallego Leon, JI and L{\'o}pez Hernandez, N and Moliner, S and Rayon, JC}, title = {Addition of intracranial aspiration to balloon guide catheter does not improve outcomes in large vessel occlusion anterior circulation stent retriever based thrombectomy for acute stroke}, volume = {14}, number = {9}, pages = {863--867}, year = {2022}, doi = {10.1136/neurintsurg-2021-017760}, publisher = {British Medical Journal Publishing Group}, abstract = {Background Balloon guide catheter (BGC) in stent retriever based thrombectomy (BGC+SR) for patients with large vessel occlusion strokes (LVOS) improves outcomes. It is conceivable that the addition of a large bore distal access catheter (DAC) to BGC+SR leads to higher efficacy. We aimed to investigate whether the combined BGC+DAC+SR approach improves angiographic and clinical outcomes compared with BGC+SR alone for thrombectomy in anterior circulation LVOS.Methods Consecutive patients with anterior circulation LVOS from June 2019 to November 2020 were recruited from the ROSSETTI registry. Demographic, clinical, angiographic, and outcome data were compared between patients treated with BGC+SR alone versus BGC+DAC+SR. The primary outcome was first pass effect (FPE) rate, defined as near complete/complete revascularization (modified Thrombolysis in Cerebral Infarction (mTICI) 2c{\textendash}3) after single device pass.Results We included 401 patients (BGC+SR alone, 273 (66.6\%) patients). Patients treated with BGC+SR alone were older (median age 79 (IQR 68{\textendash}85) vs 73.5 (65{\textendash}82) years; p=0.033) and had shorter procedural times (puncture to revascularization 24 (14{\textendash}46) vs 37 (24.5{\textendash}63.5) min, p\<0.001) than the BGC+DAC+SR group. Both approaches had a similar FPE rate (52\% in BGC+SR alone vs 46.9\% in BGC+DAC+SR, p=0.337). Although the BGC+SR alone group showed higher rates for final successful reperfusion (mTICI >=2b (86.8\% vs 74.2\%, p=0.002) and excellent reperfusion, mTICI >=2 c (76.2\% vs 55.5\%, p\<0.001)), there were no significant differences in 24 hour National Institutes of Health Stroke Scale score or rates of good functional outcome (modified Rankin Scale score of 0{\textendash}2) at 3 months across these techniques.Conclusions Our data showed that addition of distal intracranial aspiration catheters to BGC+SR based thrombectomy in patients with acute anterior circulation LVO did not provide higher rates of FPE or improved clinical outcomes.}, issn = {1759-8478}, URL = {https://jnis.bmj.com/content/14/9/863}, eprint = {https://jnis.bmj.com/content/14/9/863.full.pdf}, journal = {Journal of NeuroInterventional Surgery} }