TY - JOUR
T1 - Balloon guide catheters: use, reject, or randomize?
AU - Goyal, Mayank
AU - Kappelhof, Manon
AU - Ospel, Johanna M.
AU - Bala, Fouzi
N1 - Funding Information: Mayank Goyal is a consultant for Medtronic, Stryker, Microvention, Mentice, GE Healthcare, and holds a licensing agreement with GE Healthcare regarding systems of acute stroke diagnosis. Fouzi Bala is supported by la Société Française de Radiologie et la Société Française de Neuroradiologie. The remaining authors have nothing to disclose. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/8
Y1 - 2021/8
N2 - Thrombectomy devices played an important role in the success of endovascular treatment trials over the past five years. A balloon guide catheter (BGC) is an adjunctive device used to arrest and reverse flow by inflating the balloon at its tip, which allows for flow reversal in intracranial arteries during retrieval of thrombectomy devices by applying concomitant aspiration through its lumen. Thereby, it can decrease the risk of clot fragmentation and distal embolization. Despite the numerous benchtop and clinical observational studies showing the superiority of BGC to conventional guide catheters in improving reperfusion quality and clinical outcome, its use is still low in clinical practice. The reasons behind this reluctance might be related to technical and cost issues. Therefore, high level evidence data, i.e., a randomized clinical trial, are needed to increase its implementation in thrombectomy procedures. Nonetheless, several obstacles and challenges can prevent the completion of such a trial, and efforts are needed to overcome them. We provide an overview of the current opinions about BGCs in the neurointerventional community and discuss the feasibility and challenges of a possible randomized trial to answer the question “should a BGC be routinely used in endovascular treatment of acute ischemic stroke?”
AB - Thrombectomy devices played an important role in the success of endovascular treatment trials over the past five years. A balloon guide catheter (BGC) is an adjunctive device used to arrest and reverse flow by inflating the balloon at its tip, which allows for flow reversal in intracranial arteries during retrieval of thrombectomy devices by applying concomitant aspiration through its lumen. Thereby, it can decrease the risk of clot fragmentation and distal embolization. Despite the numerous benchtop and clinical observational studies showing the superiority of BGC to conventional guide catheters in improving reperfusion quality and clinical outcome, its use is still low in clinical practice. The reasons behind this reluctance might be related to technical and cost issues. Therefore, high level evidence data, i.e., a randomized clinical trial, are needed to increase its implementation in thrombectomy procedures. Nonetheless, several obstacles and challenges can prevent the completion of such a trial, and efforts are needed to overcome them. We provide an overview of the current opinions about BGCs in the neurointerventional community and discuss the feasibility and challenges of a possible randomized trial to answer the question “should a BGC be routinely used in endovascular treatment of acute ischemic stroke?”
KW - Balloon guide catheter
KW - Endovascular treatment
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85107537994&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00234-021-02739-2
DO - https://doi.org/10.1007/s00234-021-02739-2
M3 - Editorial
C2 - 34100099
SN - 0028-3940
VL - 63
SP - 1179
EP - 1183
JO - Neuroradiology
JF - Neuroradiology
IS - 8
ER -