Journal of Korean Neurosurgical Society

  • 제62권4호
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  • Pages.389-397
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  • 2019
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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The Effects of Balloon-Guide Catheters on Outcomes after Mechanical Thrombectomy in Acute Ischemic Strokes : A Meta-Analysis

  • Ahn, Jun Hyong (Department of Neurosurgery, Hallym University College of Medicine) ;
  • Cho, Steve S. (Perelman School of Medicine at the University of Pennsylvania) ;
  • Kim, Sung-Eun (Department of Emergency Medicine, Seoul Emergency Operations Center) ;
  • Kim, Heung Cheol (Department of Radiology, Hallym University College of Medicine) ;
  • Jeon, Jin Pyeong (Department of Neurosurgery, Hallym University College of Medicine)
  • 투고 : 2018.08.20
  • 심사 : 2018.10.12
  • 발행 : 2019.07.01
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초록

Objective : Mechanical thrombectomies with balloon-guide catheters (BGC) are thought to improve successful recanalization rates and to decrease the incidence of distal emboli compared to thrombectomies without BGC. We aimed to assess the effects of BGC on the outcomes of mechanical thrombectomy in acute ischemic strokes. Methods : Studies from PubMed, EMBASE, and the Cochrane library database from January 2010 to February 2018 were reviewed. Random effect model for meta-analysis was used. Analyses such as meta-regression and the "trim-and-fill" method were additionally carried out. Results : A total of seven articles involving 2223 patients were analyzed. Mechanical thrombectomy with BGC was associated with higher rates of successful recanalization (odds ratio [OR], 1.632; 95% confidence interval [CI], 1.293-2.059). BGC did not significantly decrease distal emboli, both before (OR, 0.404; 95% CI, 0.108-1.505) and after correcting for bias (adjusted OR, 1.165; 95% CI, 0.310-4.382). Good outcomes were observed more frequently in the BGC group (OR, 1.886; 95% CI, 1.564-2.273). Symptomatic intracranial hemorrhage and mortality did not differ significantly with BGC use. Conclusion : Our meta-analysis demonstrates that BGC enhance recanalization rates. However, BGC use did not decrease distal emboli after mechanical thrombectomies. This should be interpreted with caution due to possible publication bias and heterogeneity. Additional meta-analyses based on individual patient data are needed to clarify the role of BGC in mechanical thrombectomies.

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참고문헌

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피인용 문헌

  1. Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy vol.63, pp.1, 2019, https://doi.org/10.3340/jkns.2019.0114
  2. Balloon Guide Catheter is Not Superior to Conventional Guide Catheter when Stent Retriever and Contact Aspiration are Combined for Stroke Treatment vol.88, pp.1, 2019, https://doi.org/10.1093/neuros/nyaa315
  3. Clinical and Procedural Outcomes with or without Balloon Guide Catheters during Endovascular Thrombectomy in Acute Ischemic Stroke: A Systematic Review and Meta-analysis with First-line Technique Subg vol.42, pp.8, 2019, https://doi.org/10.3174/ajnr.a7164