Comparison of Risk of Distal Embolization between Balloon Tip Guides and Guide Sheaths during Mechanical Thrombectomy in Patients undergoing Acute Stroke Intervention

Abstract

Objective: This study compares the risk of distal embolization of balloon-tip guide catheters (BGCs) versus non-balloon-tip guide catheters (NBGCs) or Guide sheath in mechanical thrombectomy to treat acute ischemic stroke.

Methodology: This retrospective comparative study analyzed patients treated with mechanical thrombectomy for acute ischemic stroke at Rawalpindi Institute of Cardiology, from July 2022 to November 2023 after ethical approval. Patients were grouped based on balloon-tip guide catheters (BGC) versus non-balloon-tip guide catheters (NBGC) or Guide sheath. The outcome was the distal embolization rates during mechanical thrombectomy for stroke intervention. Statistical analysis was conducted by the Statistical Package for the Social Sciences (SPSS) version 25.

Results: A total of 209 patients were included, with 38 in the Balloon Tip (BGC) group and 171 in the Non-Balloon Tip (NBGC) group or Guide sheath. The age distribution, gender, and number of thrombectomy attempts were comparable between the groups, with no significant differences (p > 0.05). Femoral access was used in almost all cases. The BGC group had a slightly lower rate of distal embolism than NBGC (7.9% vs. 9.4%), but the difference was not statistically significant (p = 0.7767).

Conclusion: This study found no significant difference in distal embolism rates between Balloon Tip and Non-Balloon Tip guide catheters in mechanical thrombectomy for stroke. Despite theoretical advantages, BGCs did not show a clear clinical benefit over NBGCs. Further research is needed to determine the optimal guide catheter choice for improving patient outcomes.