Balloon guide catheter improves revascularization and clinical outcomes with the solitaire device

Analysis of the north american solitaire acute stroke registry

Thanh N. Nguyen, Timothy Malisch, Alicia C. Castonguay, Rishi Gupta, Chung Huan J. Sun, Coleman O. Martin, William E. Holloway, Nils Mueller-Kronast, Joey D. English, Italo Linfante, Guilherme Dabus, Franklin A. Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T. Rai, Michael T. Froehler, Aamir Badruddin, Muhammad Taqi, Michael G. Abraham, Vallabh Janardhan & 13 others Hashem Shaltoni, Roberta Novakovic, Albert J. Yoo, Alex Abou-Chebl, Peng R. Chen, Gavin W. Britz, Ritesh Kaushal, Ashish Nanda, Mohammad A. Issa, Hesham Masoud, Raul G. Nogueira, Alexander M. Norbash, Osama O. Zaidat

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Background and Purpose-Efficient and timely recanalization is an important goal in acute stroke endovascular therapy. Several studies demonstrated improved recanalization and clinical outcomes with the stent retriever devices compared with the Merci device. The goal of this study was to evaluate the role of the balloon guide catheter (BGC) and recanalization success in a substudy of the North American Solitaire Acute Stroke (NASA) registry. Methods-The investigator-initiated NASA registry recruited 24 clinical sites within North America to submit demographic, clinical, site-adjudicated angiographic, and clinical outcome data on consecutive patients treated with the Solitaire Flow Restoration device. BGC use was at the discretion of the treating physicians. Results-There were 354 patients included in the NASA registry. BGC data were reported in 338 of 354 patients in this subanalysis, of which 149 (44%) had placement of a BGC. Mean age was 67.3±15.2 years, and median National Institutes of Health Stroke Scale score was 18. Patients with BGC had more hypertension (82.4% versus 72.5%; P=0.05), atrial fibrillation (50.3% versus 32.8%; P=0.001), and were more commonly administered tissue plasminogen activator (51.6% versus 38.8%; P=0.02) compared with patients without BGC. Time from symptom onset to groin puncture and number of passes were similar between the 2 groups. Procedure time was shorter in patients with BGC (120±28.5 versus 161±35.6 minutes; P=0.02), and less adjunctive therapy was used in patients with BGC (20% versus 28.6%; P=0.05). Thrombolysis in cerebral infarction 3 reperfusion scores were higher in patients with BGC (53.7% versus 32.5%; P<0.001). Distal emboli and emboli in new territory were similar between the 2 groups. Discharge National Institutes of Health Stroke Scale score (mean, 12±14.5 versus 17.5±16; P=0.002) and good clinical outcome at 3 months were superior in patients with BGC compared with patients without (51.6% versus 35.8%; P=0.02). Multivariate analysis demonstrated that the use of BGC was an independent predictor of good clinical outcome (odds ratio, 2.5; 95% confidence interval, 1.2-4.9). Conclusions-Use of a BGC with the Solitaire Flow Restoration device resulted in superior revascularization results, faster procedure times, decreased need for adjunctive therapy, and improved clinical outcome.

Original languageEnglish (US)
Pages (from-to)141-145
Number of pages5
JournalStroke
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Registries
Catheters
Stroke
Equipment and Supplies
National Institutes of Health (U.S.)
Embolism
Groin
Cerebral Infarction
Hong Kong
Tissue Plasminogen Activator
North America
Punctures
Atrial Fibrillation
Reperfusion
Stents
Therapeutics
Multivariate Analysis
Odds Ratio
Research Personnel
Demography

Keywords

  • Stroke
  • Thrombectomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Balloon guide catheter improves revascularization and clinical outcomes with the solitaire device : Analysis of the north american solitaire acute stroke registry. / Nguyen, Thanh N.; Malisch, Timothy; Castonguay, Alicia C.; Gupta, Rishi; Sun, Chung Huan J.; Martin, Coleman O.; Holloway, William E.; Mueller-Kronast, Nils; English, Joey D.; Linfante, Italo; Dabus, Guilherme; Marden, Franklin A.; Bozorgchami, Hormozd; Xavier, Andrew; Rai, Ansaar T.; Froehler, Michael T.; Badruddin, Aamir; Taqi, Muhammad; Abraham, Michael G.; Janardhan, Vallabh; Shaltoni, Hashem; Novakovic, Roberta; Yoo, Albert J.; Abou-Chebl, Alex; Chen, Peng R.; Britz, Gavin W.; Kaushal, Ritesh; Nanda, Ashish; Issa, Mohammad A.; Masoud, Hesham; Nogueira, Raul G.; Norbash, Alexander M.; Zaidat, Osama O.

In: Stroke, Vol. 45, No. 1, 01.01.2014, p. 141-145.

Research output: Contribution to journalArticle

Nguyen, TN, Malisch, T, Castonguay, AC, Gupta, R, Sun, CHJ, Martin, CO, Holloway, WE, Mueller-Kronast, N, English, JD, Linfante, I, Dabus, G, Marden, FA, Bozorgchami, H, Xavier, A, Rai, AT, Froehler, MT, Badruddin, A, Taqi, M, Abraham, MG, Janardhan, V, Shaltoni, H, Novakovic, R, Yoo, AJ, Abou-Chebl, A, Chen, PR, Britz, GW, Kaushal, R, Nanda, A, Issa, MA, Masoud, H, Nogueira, RG, Norbash, AM & Zaidat, OO 2014, 'Balloon guide catheter improves revascularization and clinical outcomes with the solitaire device: Analysis of the north american solitaire acute stroke registry', Stroke, vol. 45, no. 1, pp. 141-145. https://doi.org/10.1161/STROKEAHA.113.002407
Nguyen, Thanh N. ; Malisch, Timothy ; Castonguay, Alicia C. ; Gupta, Rishi ; Sun, Chung Huan J. ; Martin, Coleman O. ; Holloway, William E. ; Mueller-Kronast, Nils ; English, Joey D. ; Linfante, Italo ; Dabus, Guilherme ; Marden, Franklin A. ; Bozorgchami, Hormozd ; Xavier, Andrew ; Rai, Ansaar T. ; Froehler, Michael T. ; Badruddin, Aamir ; Taqi, Muhammad ; Abraham, Michael G. ; Janardhan, Vallabh ; Shaltoni, Hashem ; Novakovic, Roberta ; Yoo, Albert J. ; Abou-Chebl, Alex ; Chen, Peng R. ; Britz, Gavin W. ; Kaushal, Ritesh ; Nanda, Ashish ; Issa, Mohammad A. ; Masoud, Hesham ; Nogueira, Raul G. ; Norbash, Alexander M. ; Zaidat, Osama O. / Balloon guide catheter improves revascularization and clinical outcomes with the solitaire device : Analysis of the north american solitaire acute stroke registry. In: Stroke. 2014 ; Vol. 45, No. 1. pp. 141-145.
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abstract = "Background and Purpose-Efficient and timely recanalization is an important goal in acute stroke endovascular therapy. Several studies demonstrated improved recanalization and clinical outcomes with the stent retriever devices compared with the Merci device. The goal of this study was to evaluate the role of the balloon guide catheter (BGC) and recanalization success in a substudy of the North American Solitaire Acute Stroke (NASA) registry. Methods-The investigator-initiated NASA registry recruited 24 clinical sites within North America to submit demographic, clinical, site-adjudicated angiographic, and clinical outcome data on consecutive patients treated with the Solitaire Flow Restoration device. BGC use was at the discretion of the treating physicians. Results-There were 354 patients included in the NASA registry. BGC data were reported in 338 of 354 patients in this subanalysis, of which 149 (44{\%}) had placement of a BGC. Mean age was 67.3±15.2 years, and median National Institutes of Health Stroke Scale score was 18. Patients with BGC had more hypertension (82.4{\%} versus 72.5{\%}; P=0.05), atrial fibrillation (50.3{\%} versus 32.8{\%}; P=0.001), and were more commonly administered tissue plasminogen activator (51.6{\%} versus 38.8{\%}; P=0.02) compared with patients without BGC. Time from symptom onset to groin puncture and number of passes were similar between the 2 groups. Procedure time was shorter in patients with BGC (120±28.5 versus 161±35.6 minutes; P=0.02), and less adjunctive therapy was used in patients with BGC (20{\%} versus 28.6{\%}; P=0.05). Thrombolysis in cerebral infarction 3 reperfusion scores were higher in patients with BGC (53.7{\%} versus 32.5{\%}; P<0.001). Distal emboli and emboli in new territory were similar between the 2 groups. Discharge National Institutes of Health Stroke Scale score (mean, 12±14.5 versus 17.5±16; P=0.002) and good clinical outcome at 3 months were superior in patients with BGC compared with patients without (51.6{\%} versus 35.8{\%}; P=0.02). Multivariate analysis demonstrated that the use of BGC was an independent predictor of good clinical outcome (odds ratio, 2.5; 95{\%} confidence interval, 1.2-4.9). Conclusions-Use of a BGC with the Solitaire Flow Restoration device resulted in superior revascularization results, faster procedure times, decreased need for adjunctive therapy, and improved clinical outcome.",
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TY - JOUR

T1 - Balloon guide catheter improves revascularization and clinical outcomes with the solitaire device

T2 - Analysis of the north american solitaire acute stroke registry

AU - Nguyen, Thanh N.

AU - Malisch, Timothy

AU - Castonguay, Alicia C.

AU - Gupta, Rishi

AU - Sun, Chung Huan J.

AU - Martin, Coleman O.

AU - Holloway, William E.

AU - Mueller-Kronast, Nils

AU - English, Joey D.

AU - Linfante, Italo

AU - Dabus, Guilherme

AU - Marden, Franklin A.

AU - Bozorgchami, Hormozd

AU - Xavier, Andrew

AU - Rai, Ansaar T.

AU - Froehler, Michael T.

AU - Badruddin, Aamir

AU - Taqi, Muhammad

AU - Abraham, Michael G.

AU - Janardhan, Vallabh

AU - Shaltoni, Hashem

AU - Novakovic, Roberta

AU - Yoo, Albert J.

AU - Abou-Chebl, Alex

AU - Chen, Peng R.

AU - Britz, Gavin W.

AU - Kaushal, Ritesh

AU - Nanda, Ashish

AU - Issa, Mohammad A.

AU - Masoud, Hesham

AU - Nogueira, Raul G.

AU - Norbash, Alexander M.

AU - Zaidat, Osama O.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background and Purpose-Efficient and timely recanalization is an important goal in acute stroke endovascular therapy. Several studies demonstrated improved recanalization and clinical outcomes with the stent retriever devices compared with the Merci device. The goal of this study was to evaluate the role of the balloon guide catheter (BGC) and recanalization success in a substudy of the North American Solitaire Acute Stroke (NASA) registry. Methods-The investigator-initiated NASA registry recruited 24 clinical sites within North America to submit demographic, clinical, site-adjudicated angiographic, and clinical outcome data on consecutive patients treated with the Solitaire Flow Restoration device. BGC use was at the discretion of the treating physicians. Results-There were 354 patients included in the NASA registry. BGC data were reported in 338 of 354 patients in this subanalysis, of which 149 (44%) had placement of a BGC. Mean age was 67.3±15.2 years, and median National Institutes of Health Stroke Scale score was 18. Patients with BGC had more hypertension (82.4% versus 72.5%; P=0.05), atrial fibrillation (50.3% versus 32.8%; P=0.001), and were more commonly administered tissue plasminogen activator (51.6% versus 38.8%; P=0.02) compared with patients without BGC. Time from symptom onset to groin puncture and number of passes were similar between the 2 groups. Procedure time was shorter in patients with BGC (120±28.5 versus 161±35.6 minutes; P=0.02), and less adjunctive therapy was used in patients with BGC (20% versus 28.6%; P=0.05). Thrombolysis in cerebral infarction 3 reperfusion scores were higher in patients with BGC (53.7% versus 32.5%; P<0.001). Distal emboli and emboli in new territory were similar between the 2 groups. Discharge National Institutes of Health Stroke Scale score (mean, 12±14.5 versus 17.5±16; P=0.002) and good clinical outcome at 3 months were superior in patients with BGC compared with patients without (51.6% versus 35.8%; P=0.02). Multivariate analysis demonstrated that the use of BGC was an independent predictor of good clinical outcome (odds ratio, 2.5; 95% confidence interval, 1.2-4.9). Conclusions-Use of a BGC with the Solitaire Flow Restoration device resulted in superior revascularization results, faster procedure times, decreased need for adjunctive therapy, and improved clinical outcome.

AB - Background and Purpose-Efficient and timely recanalization is an important goal in acute stroke endovascular therapy. Several studies demonstrated improved recanalization and clinical outcomes with the stent retriever devices compared with the Merci device. The goal of this study was to evaluate the role of the balloon guide catheter (BGC) and recanalization success in a substudy of the North American Solitaire Acute Stroke (NASA) registry. Methods-The investigator-initiated NASA registry recruited 24 clinical sites within North America to submit demographic, clinical, site-adjudicated angiographic, and clinical outcome data on consecutive patients treated with the Solitaire Flow Restoration device. BGC use was at the discretion of the treating physicians. Results-There were 354 patients included in the NASA registry. BGC data were reported in 338 of 354 patients in this subanalysis, of which 149 (44%) had placement of a BGC. Mean age was 67.3±15.2 years, and median National Institutes of Health Stroke Scale score was 18. Patients with BGC had more hypertension (82.4% versus 72.5%; P=0.05), atrial fibrillation (50.3% versus 32.8%; P=0.001), and were more commonly administered tissue plasminogen activator (51.6% versus 38.8%; P=0.02) compared with patients without BGC. Time from symptom onset to groin puncture and number of passes were similar between the 2 groups. Procedure time was shorter in patients with BGC (120±28.5 versus 161±35.6 minutes; P=0.02), and less adjunctive therapy was used in patients with BGC (20% versus 28.6%; P=0.05). Thrombolysis in cerebral infarction 3 reperfusion scores were higher in patients with BGC (53.7% versus 32.5%; P<0.001). Distal emboli and emboli in new territory were similar between the 2 groups. Discharge National Institutes of Health Stroke Scale score (mean, 12±14.5 versus 17.5±16; P=0.002) and good clinical outcome at 3 months were superior in patients with BGC compared with patients without (51.6% versus 35.8%; P=0.02). Multivariate analysis demonstrated that the use of BGC was an independent predictor of good clinical outcome (odds ratio, 2.5; 95% confidence interval, 1.2-4.9). Conclusions-Use of a BGC with the Solitaire Flow Restoration device resulted in superior revascularization results, faster procedure times, decreased need for adjunctive therapy, and improved clinical outcome.

KW - Stroke

KW - Thrombectomy

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