Safety and feasibility of transradial use of 8F balloon guide catheter Flowgate2 for endovascular thrombectomy in acute ischemic stroke.

Abstract

BACKGROUND\nWhile Balloon Guide Catheters (BGC) have been shown to increase the rate of reperfusion during mechanical thrombectomy (MT), its implementation with transfemoral approach is at times limited due to unfavorable vascular anatomy.\n\n\nOBJECTIVE\nto determine safety, feasibility and performance of the transradial use of 8\u2009F BGC Flowgate2 during mechanical thrombectomy procedures in patients with unfavorable vascular anatomies (type 3 or bovine arch)Material/Methods: We performed a retrospective cohort study of consecutive transradial mechanical thrombectomies performed with BGC Flowgate2 between January and December 2019. Patient demographics, procedural and radiographic metrics, and clinical data were analyzed.\n\n\nRESULTS\n20 (8.7%) out of 230 overall thrombectomy procedures underwent transradial approach using an 8\u2009F BGC Flowgate.2 Successful approach was achieved in 17/20 cases, and in 3 cases radial was switched to femoral, after failure. TICI 2\u2009C/3 was achieved in 18 cases (90%), followed by TICI 2\u2009b and 2a in 1 (5%) case respectively. The average number of passes was 1.8. The average radial puncture-to-first pass time was 22\u2009min. Radial vasospasm was observed in 3/20 cases. The Flowgate2 was found kinked in 4/20 cases (20%), all of them during right internal carotid procedures. There were no postprocedural complications at puncture site, as hematoma, pseudoaneurysm or local ischemic events.\n\n\nCONCLUSION\nThe use of 8\u2009F Balloon Guide Catheter during MT via transradial approach might represent an alternative in selected cases with unfavorable vascular anatomies. Its use in right ICA catheterizations was associated with a high rate of catheter kinking.