The use of a (non-) balloon guide catheter in endovascular stroke treatment, a registry of real-life use and nationwide questionnaire

J Stroke Cerebrovasc Dis. 2024 Dec;33(12):108033. doi: 10.1016/j.jstrokecerebrovasdis.2024.108033. Epub 2024 Oct 3.

Abstract

Introduction: Despite literature suggesting benefits of a balloon guide catheter (BGC) in stroke thrombectomy, BGCs are not routinely used. This study aimed to get insights in the use of a BGC and the reasons (not) to inflate the balloon.

Methods: Data were used of the Maastricht Stroke Quality Registry (MaSQ-Registry), a prospective registry for quality purposes of stroke patients treated between September 2020-February 2023. Additionally, a Dutch nationwide questionnaire was sent among all stroke treating physicians of the Dutch Society of Interventional Radiology (NVIR). Information on the use and reasons for selecting a (non-)BGC and using the BGC was collected.

Results: Out of 511 patients registered in the MaSQ-Registry, 458 were included. In 69% (n=317) of the patients a BGC was used; in 68% (n=214) the balloon was not inflated. In 95% of the posterior circulation occlusions a non-BGC was used. In total 47 treating physicians from sixteen stroke centers responded to the questionnaire. 51% (n=24) preferred a non-BGC and 30% (n=14) never used a BGC. 52% and 18% of the BGC-users estimated they inflate the balloon in 80-100% and 0-20% of the times, respectively. The main reasons reported for not inflating the balloon were when the BGC was occlusive (47%) or not placeable (34%) in the carotid artery.

Conclusion: This study shows variation in the use of (non-)BGC use with and without inflated balloon among treating physicians in the Netherlands, highlighting current limited consensus regarding the use of (non-)BGCs among stroke treating physicians.

Keywords: Acute ischemic stroke (AIS); Balloon guide catheter (BGC); Intra-arterial thrombectomy (IAT); Stroke – Endovascular treatment (EVT); Survey.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon / instrumentation
  • Equipment Design
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Practice Patterns, Physicians'*
  • Registries*
  • Stroke* / diagnosis
  • Stroke* / therapy
  • Surveys and Questionnaires
  • Thrombectomy / instrumentation
  • Treatment Outcome
  • Vascular Access Devices