Efficacy and Safety of Balloon Guide Catheter in Mechanical Thrombectomy Patients

• Balloon guide catheter (Device): Use a balloon guide catheter in the mechanical thrombectomy
• Non-balloon guide catheter (Device): Use a non-balloon guide catheter in the mechanical thrombectomy

Primary outcomes

• Distal embolization, [After mechanical thrombectomy, usually within 3 hours]

Secondary outcomes

• Modified thrombolysis in cerebral infarction 2b/3, [After mechanical thrombectomy, usually within 3 hours]
• Modified thrombolysis in cerebral infarction [After mechanical thrombectomy, usually within 3 hours]
• Modified thrombolysis in cerebral infarction 2b/3 after the first pass [After the first pass, , usually within 3 hours]
• First pass recanalization rate [After the first pass, , usually within 3 hours]
• Number of passes [After mechanical thrombectomy, usually within 3 hours]
• Procedure time [From the procedure start to the end, usually within 3 hours]
• National Institutes of Health Stroke Scale [7 days or discharge]: Scores on the National Institutes of Health Stroke Scale (NIHSS) range from 0 to 42, with higher scores indicating more severe neurologic deficits.
• Symptomatic intracranial hemorrhage [24 hours]
• Modified Rankin Scale [90 days]: Scores on the modified Rankin scale of functional disability range from 0 (no symptoms) to 6 (death).
• Mortality [90 days]

Other outcomes

• Safety (occurrence of adverse events and serious adverse events) [7 days]

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Age 18 years or older
* A clinical diagnosis of acute stroke, with a deficit on the NIHSS of 2 points or more.
* Intracranial arterial occlusion of the distal intracranial carotid artery or middle (M1/M2) or anterior (A1/A2) cerebral artery, demonstrated with CTA, MRA, or DSA.
* Treatment can be initiated (groin puncture) within 6 hours of symptom onset.
* Planning to mechanical thrombectomy with a stenting retriever.
* Signed informed consent prior to entering study.

Exclusion Criteria:

* Moderate stenosis, severe stenosis, or occlusion of the ipsilateral extracranial carotid artery.
* Previously deployed stents in the ipsilateral carotid artery.
* Dissections of the ipsilateral carotid artery.
* Known hemorrhagic diathesis, coagulation factor deficiency, or oral anticoagulant therapy with INR > 3.0.
* Baseline platelet count < 50.000/µL.
* Baseline blood glucose of < 50mg/dL or >400mg/dl.
* Severe, sustained hypertension (SBP > 220 mm Hg or DBP > 110 mm Hg).
* Renal insufficiency with creatinine ≥ 3 mg/dl.
* Patients in sedation and intubated patients could not be included if baseline NIHSS is not obtained by a neurologist or emergency physician prior to sedation or intubation.
* Seizures at stroke onset which would preclude obtaining a baseline NIHSS.
* Unlikely to be available for 90 days follow-up (e.g. no fixed home address, visitor from overseas).
* Subject participating in a study involving an investigational drug or device that would impact this study.

• Results publication: Ma H, Che R, Zhang Q, Yu W, Wu L, Zhao W, Li M, Wu D, Wu C, Ji X. The optimum anticoagulation time after endovascular thrombectomy for atrial fibrillation-related large vessel occlusion stroke: a real-world study. J Neurol. 2023 Apr;270(4):2084-2095. doi: 10.1007/s00415-022-11515-y. Epub 2023 Jan 3. PMID 36596867