ArticleClinical neuroradiology2026
Balloon Guide Catheter Use and Outcomes After Endovascular Thrombectomy for Ischemic Stroke Due to Large Vessel Occlusions.
Article in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBalloon-guide catheters (BGC) have been associated with improved procedural and functional outcomes following endovascular thrombectomy (EVT) in multiple observational studies. Recently the PROTECT-MT trial challenged this benefit, showing worse functional outcomes when using BGCs. This study aims to assess the association between BGC-use and procedural and functional outcomes in a large real-world cohort.
methodsPatients who underwent EVT for anterior circulation large vessel occlusion (LVO) between 2017 and 2021 were included in two Swedish registries: EVAS and Riksstroke. Outcomes included recanalization success (modified Treatment In Cerebral Infarction [mTICI] 2b/2c-3), good 90-day functional outcome (modified Rankin Scale score 0-2), and safety outcomes (iatrogenic dissection, perioperative embolization, early neurological deterioration, and 90-day mortality). Subgroup analysis was conducted by first-line EVT strategy: stent-retriever (with/without aspiration) or contact aspiration alone.
resultsOf 4843 patients, 2483 met the inclusion criteria. BGCs were used in 1449 cases (58.4%) and were more frequently used with stent-retrievers (83.0%) than with contact aspiration (24.1%, p < 0.001). BGC-use was associated with higher rates of excellent recanalization (mTICI 2c-3) and first-pass success, particularly in stent-retriever cases (p < 0.001), but not with good recanalization (mTICI 2b-3). No association was found with good 90-day functional outcome or any safety outcome (p > 0.05). A numerically lower mortality rate was observed with BGCs (19.0% vs. 22.9%, p = 0.019), although this was not significant after adjustment.
conclusionsBGC-use during EVT was associated with excellent recanalization and first-pass reperfusion, primarily in stent-retriever-treated patients. No significant impact on 90-day functional outcome nor on safety indicators was observed.
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