TY - JOUR T1 - 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 JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 863 LP - 867 DO - 10.1136/neurintsurg-2021-017760 VL - 14 IS - 9 AU - Jordi Blasco AU - Josep Puig AU - Antonio López-Rueda AU - Pepus Daunis-i-Estadella AU - Laura Llull AU - Federico Zarco AU - Napoleon Macias AU - Juan Macho AU - Eva González AU - Ion Labayen AU - Pedro Vega AU - Eduardo Murias AU - Elvira Jimenez-Gomez AU - Isabel Bravo Rey AU - Manuel Moreu AU - Carlos Pérez-García AU - Oscar Chirife Chaparro AU - Sonia Aixut AU - Mikel Terceño AU - Mariano Werner AU - José Manuel Pumar AU - Yeray Aguilar Tejedor AU - Jose Carlos Mendez AU - Sarai Moliner AU - Raul G Nogueira AU - Luis San Roman A2 - , Y1 - 2022/09/01 UR - http://jnis.bmj.com/content/14/9/863.abstract N2 - 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–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 68–85) vs 73.5 (65–82) years; p=0.033) and had shorter procedural times (puncture to revascularization 24 (14–46) vs 37 (24.5–63.5) 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 0–2) 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. ER -