Impact of Balloon Guide Catheters in Elderly Patients Treated with Mechanical Thrombectomy: Insights from the ROSSETTI Registry

Mikel Terceño¹, Saima Bashir², Josep Puig³, Josep Daunis- I-Estadella⁴, Eduardo Murias⁵, Jose María Jiménez⁵, Eva González Díaz⁶, Jon Fondevila Monso⁶, Isabel Bravo-Rey⁷, Veredas Romero⁷, Mariano Werner⁸, Antonio López-Rueda⁹, Luis San Román⁹, Jordi Blasco Anadaluz⁹, Antonio Doncel-Moriano¹⁰, Santiago Rosati¹¹, Carlos Pérez-García¹¹, Sebastian Remollo¹², Isabel Rodríguez Caamaño¹², Sonia Aixut¹³, Oscar Sabino Chirife Chaparro¹³, Juan Manuel Sanchis Garcia¹⁴, Jacobo Porto-Álvarez¹⁵, Jose Carlos Mendez-Cendón¹⁶, Jose Carlos Rayon-Aledo¹⁷, Yeray Aguilar¹⁸, Guillermo Parrilla¹⁹, Miguel Castaño²⁰, Joaquín Serena¹, Yolanda Silva¹

Affiliations

¹ From the Stroke Unit, Department of Neurology (M.T., S.B., J.S., Y.S.), Hospital Universitari Doctor Josep Trueta de, Girona, Girona Biomedical Research Institute, Girona, Spain.
² From the Stroke Unit, Department of Neurology (M.T., S.B., J.S., Y.S.), Hospital Universitari Doctor Josep Trueta de, Girona, Girona Biomedical Research Institute, Girona, Spain sbashir.girona.ics@gencat.cat.
³ Department of Radiology (J.P.), Hospital Universitari de Girona Doctor Josep Trueta, Girona, Catalunya, Spain.
⁴ Department of Computer Science (J.D.-I.-E.), Applied Mathematics and Statistics, University of Girona, Girona, Catalunya, Spain.
⁵ Department of Radiology (E.M., J.M.J.), Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
⁶ Department of Interventional Neuroradiology (E.G.D., J.F.M.), Department of Radiology, Cruces University Hospital, Barakaldo, PaísVasco, Spain.
⁷ Diagnostic and Therapeutical Neuroradiology Unit (I.B.-R., V.R.), Reina Sofia University Hospital, Cordoba, Andalucía, Spain.
⁸ Neurointerventional Department CDI (M.W.), Hospital Clinic de Barcelona, Barcelona, Spain.
⁹ Department of Interventional Neuroradiology (A.L.-R., L.S.R., J.B.A.), Clinic University Hospital, Barcelona, Barcelona, Spain.
¹⁰ Department of Neurology (A.D.-M.), Hospital Clinic de Barcelona, Barcelona, Spain.
¹¹ Department of Interventional Neurorradiology (S.R., C.P.-G.), Department of Radiology, Hospital Universitario Clínico San Carlos, Madrid, Spain.
¹² Department of Interventional Neuroradiology (S.R., I.R.C.), Hospital universitari Germans Trias i Pujol, Badalona, Spain.
¹³ Department of Interventional Neuroradiology (S.A., O.S.C.C.), Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
¹⁴ Neuroradiology Unit (J.M.S.G.), Hospital Universitario y Politécnico La Fe, Valencia, Spain.
¹⁵ Department of Neuroradiology (J.P.-A.), Complexo Hospitalario Universitario de Santiago de, Compostela, Galicia, Spain.
¹⁶ Interventional Neuroradiology Unit (J.C.M.-C.), Department of Radiology, Hospital Ramón y Cajal, Madrid, Spain.
¹⁷ Department of Interventional Neuroradiology (J.C.R.-A.), Hospital General Universitario de Alicante, Alicante, Valenciana, Spain.
¹⁸ Department of Radiology (Y.A.), Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
¹⁹ Department of Interventional Neuroradiology (G.P.), Department of Radiology, Hospital Clínico Universitario Virgen de la, Murcia, Spain.
²⁰ Department of Interventional Neuroradiology (M.S.), Hospital Clínico Universitario de Salamanca, Salamanca, Spain.

PMID: 37827717
PMCID: PMC10631533
DOI: 10.3174/ajnr.A8003

Impact of Balloon Guide Catheters in Elderly Patients Treated with Mechanical Thrombectomy: Insights from the ROSSETTI Registry

Mikel Terceño et al. AJNR Am J Neuroradiol. 2023 Nov.

. 2023 Nov;44(11):1275-1281.

doi: 10.3174/ajnr.A8003. Epub 2023 Oct 12.

Authors

Affiliations

¹ From the Stroke Unit, Department of Neurology (M.T., S.B., J.S., Y.S.), Hospital Universitari Doctor Josep Trueta de, Girona, Girona Biomedical Research Institute, Girona, Spain.
² From the Stroke Unit, Department of Neurology (M.T., S.B., J.S., Y.S.), Hospital Universitari Doctor Josep Trueta de, Girona, Girona Biomedical Research Institute, Girona, Spain sbashir.girona.ics@gencat.cat.
³ Department of Radiology (J.P.), Hospital Universitari de Girona Doctor Josep Trueta, Girona, Catalunya, Spain.
⁴ Department of Computer Science (J.D.-I.-E.), Applied Mathematics and Statistics, University of Girona, Girona, Catalunya, Spain.
⁵ Department of Radiology (E.M., J.M.J.), Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
⁶ Department of Interventional Neuroradiology (E.G.D., J.F.M.), Department of Radiology, Cruces University Hospital, Barakaldo, PaísVasco, Spain.
⁷ Diagnostic and Therapeutical Neuroradiology Unit (I.B.-R., V.R.), Reina Sofia University Hospital, Cordoba, Andalucía, Spain.
⁸ Neurointerventional Department CDI (M.W.), Hospital Clinic de Barcelona, Barcelona, Spain.
⁹ Department of Interventional Neuroradiology (A.L.-R., L.S.R., J.B.A.), Clinic University Hospital, Barcelona, Barcelona, Spain.
¹⁰ Department of Neurology (A.D.-M.), Hospital Clinic de Barcelona, Barcelona, Spain.
¹¹ Department of Interventional Neurorradiology (S.R., C.P.-G.), Department of Radiology, Hospital Universitario Clínico San Carlos, Madrid, Spain.
¹² Department of Interventional Neuroradiology (S.R., I.R.C.), Hospital universitari Germans Trias i Pujol, Badalona, Spain.
¹³ Department of Interventional Neuroradiology (S.A., O.S.C.C.), Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
¹⁴ Neuroradiology Unit (J.M.S.G.), Hospital Universitario y Politécnico La Fe, Valencia, Spain.
¹⁵ Department of Neuroradiology (J.P.-A.), Complexo Hospitalario Universitario de Santiago de, Compostela, Galicia, Spain.
¹⁶ Interventional Neuroradiology Unit (J.C.M.-C.), Department of Radiology, Hospital Ramón y Cajal, Madrid, Spain.
¹⁷ Department of Interventional Neuroradiology (J.C.R.-A.), Hospital General Universitario de Alicante, Alicante, Valenciana, Spain.
¹⁸ Department of Radiology (Y.A.), Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
¹⁹ Department of Interventional Neuroradiology (G.P.), Department of Radiology, Hospital Clínico Universitario Virgen de la, Murcia, Spain.
²⁰ Department of Interventional Neuroradiology (M.S.), Hospital Clínico Universitario de Salamanca, Salamanca, Spain.

PMID: 37827717
PMCID: PMC10631533
DOI: 10.3174/ajnr.A8003

Abstract

Background and purpose: Several nonrandomized studies have demonstrated the effectiveness of balloon guide catheters in treating patients with anterior circulation large-vessel occlusion. However, their impact on the elderly populations has been underreported. We aimed to analyze the effect of balloon guide catheters in a cohort of elderly patients (80 years of age or older) with anterior circulation large-vessel occlusion.

Materials and methods: Consecutive patients from June 2019 to June 2022 were collected from the ROSSETTI Registry. Demographic and clinical data, angiographic endovascular technique, and clinical outcome were compared between balloon guide catheter and non-balloon guide catheter groups. We studied the association between balloon guide catheters and the rate of complete recanalization after a single first-pass effect modified TICI 2c-3, as well as their association with functional independence at 3 months.

Results: A total of 808 patients were included during this period, 465 (57.5%) of whom were treated with balloon guide catheters. Patients treated with balloon guide catheters were older, had more neurologic severity at admission and lower baseline ASPECTS, and were less likely to receive IV fibrinolytics. No differences were observed in terms of the modified first-pass effect between groups (45.8 versus 39.9%, P = .096). In the multivariable regression analysis, balloon guide catheter use was not independently associated with a modified first-pass effect or the final modified TICI 2c-3, or with functional independence at 3 months.

Conclusions: In our study, balloon guide catheter use during endovascular treatment of anterior circulation large-vessel occlusion in elderly patients did not predict the first-pass effect, near-complete final recanalization, or functional independence at 3 months. Further studies, including randomized clinical trials, are needed to confirm these results.

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Figures

**FIG 1.**
Distribution of the final mTICI according to BGC versus non-BGC use.

**FIG 2.**
Distribution of mRS at 3 months according to BGC versus non-BGC use.

See this image and copyright information in PMC

References

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Impact of Balloon Guide Catheters in Elderly Patients Treated with Mechanical Thrombectomy: Insights from the ROSSETTI Registry

Affiliations

Impact of Balloon Guide Catheters in Elderly Patients Treated with Mechanical Thrombectomy: Insights from the ROSSETTI Registry

Authors

Affiliations

Abstract

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical