BACKGROUND The effectiveness of balloon guide catheter (BGC) use has not been prospectively studied and its added value for improving reperfusion in acute ischemic stroke (AIS) treatment has only been reported in studies in which no contact aspiration was combined with the stent retriever (CA + SR). OBJECTIVE To compare the reperfusion results and clinical outcomes with and without BGC use when a combined CA + SR strategy is employed in first line to treat AIS. METHODS From January 2016 to April 2019, data from the ETIS registry (Endovascular Treatment in Ischemic Stroke) were reviewed. We included patients having undergone endovascular treatment with a combined CA + SR strategy and use or not of a BGC according to the operator's discretion. We compared BGC and nonBGC populations with matching and inverse probability of treatment weighting propensity scores. Primary outcome was the final near-complete/complete revascularization (mTICI2c/3) rate. Secondary outcomes included clinical outcomes and safety considerations. RESULTS Among 607 included patients, BGC was used in 32.9% (n = 200), and 190 matched pairs could be found. We found no significant difference in final mTICI2c/3 between patients with and without BGC (60.1% in BGC group compared to 62.7% in nonBGC group (matched RR, 0.92; 95%CI, 0.80 to 1.14)), first-pass mTICI2c/3 (35.1% vs 37.3%, matched RR, 0.94; 95%CI, 0.68 to 1.30), clinical outcome (matched RR of 1.12 (95%CI, 0.85 to 1.47) for favorable outcome. CONCLUSION The reperfusion and clinical results with and without BGC use are not significantly different when combined CA + SR are used as a first-line strategy for large vessel occlusion in the setting of AIS.

中文翻译：

---

当支架取出器和接触抽吸结合用于中风治疗时，球囊引导导管并不优于传统引导导管

背景 尚未对球囊导管 (BGC) 使用的有效性进行前瞻性研究，其在改善急性缺血性卒中 (AIS) 治疗中的再灌注方面的附加价值仅在未接触抽吸与支架取栓器 (CA + SR）。目的 比较在一线采用联合 CA + SR 策略治疗 AIS 时使用和不使用 BGC 的再灌注结果和临床结果。方法 从 2016 年 1 月至 2019 年 4 月，回顾了来自 ETIS 注册（缺血性卒中的血管内治疗）的数据。我们纳入了采用联合 CA + SR 策略进行血管内治疗并根据操作者的判断是否使用 BGC 的患者。我们将 BGC 和非 BGC 人群与治疗加权倾向评分的匹配和逆概率进行了比较。主要结果是最终的接近完全/完全血运重建 (mTICI2c/3) 率。次要结果包括临床结果和安全考虑。结果 在纳入的 607 例患者中，32.9%（n = 200）使用了 BGC，并且可以找到 190 个匹配对。我们发现有和没有 BGC 的患者的最终 mTICI2c/3 没有显着差异（BGC 组为 60.1%，而非 BGC 组为 62.7%（匹配 RR，0.92；95%CI，0.80 至 1.14）），首次通过 mTICI2c/ 3（35.1% 与 37.3%，匹配 RR，0.94；95%CI，0.68 至 1.30），临床结果（匹配 RR 为 1.12（95%CI，0.85 至 1.47）以获得有利结果。