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Research ArticleInterventional

Balloon-Guide Catheters Are Needed for Effective Flow Reversal during Mechanical Thrombectomy

O. Nikoubashman, D. Wischer, H.M. Hennemann, J. Sandmann, T. Sichtermann, F.S. Müschenich, A. Reich and M. Wiesmann
American Journal of Neuroradiology November 2018, 39 (11) 2077-2081; DOI: https://doi.org/10.3174/ajnr.A5829
O. Nikoubashman
aFrom the Departments of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., J.S., T.S., F.S.M., M.W.)
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  • ORCID record for O. Nikoubashman
D. Wischer
aFrom the Departments of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., J.S., T.S., F.S.M., M.W.)
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H.M. Hennemann
aFrom the Departments of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., J.S., T.S., F.S.M., M.W.)
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J. Sandmann
aFrom the Departments of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., J.S., T.S., F.S.M., M.W.)
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T. Sichtermann
aFrom the Departments of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., J.S., T.S., F.S.M., M.W.)
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F.S. Müschenich
aFrom the Departments of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., J.S., T.S., F.S.M., M.W.)
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A. Reich
bNeurology (A.R.), RWTH Aachen University Hospital, Aachen, Germany.
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M. Wiesmann
aFrom the Departments of Diagnostic and Interventional Neuroradiology (O.N., D.W., H.M.H., J.S., T.S., F.S.M., M.W.)
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    Fig 1.

    Schematic illustration of the porcine anatomy and the experimental setup. The catheter (thick gray line) is placed in the common carotid artery, which has a diameter comparable with that of the human internal carotid artery. The flow in the CCA was reduced to comparable values by clogging the subsequent vessels. US indicates sonography probe; ECA, external carotid artery; MA, maxillary artery; AP, ascending pharyngeal artery; RM, rete mirabile; CW, circle of Willis. Note that swine have a true bovine arch and that the internal carotid arteries arise from the rete mirabile, which is a spongiform conglomerate of blood vessels that serves as a filter for clots.

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    Fig 2.

    A, Typical sonography blood flow profile in the common carotid artery in our model. B, Typical flow profile in the common carotid artery during pump aspiration through an 8F sheath. Note that the profile is almost unchanged and flow remains antegrade. C, This feature is likely because aspiration results in an additional pressure gradient that mobilizes additional flow from the aortic arch into the CCA along the catheter (C, light arrows), while antegrade flow in the distal CCA is maintained (C, dark arrows).

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    Fig 3.

    Oscillatory blood flow with antegrade flow in systole and retrograde flow in diastole after manual aspiration through the 8F sheath.

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    Fig 4.

    A, Balloon inflation results in flow arrest in the CCA. B, Manual aspiration through an inflated BGC results in a constant and significant flow reversal.

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American Journal of Neuroradiology: 39 (11)
American Journal of Neuroradiology
Vol. 39, Issue 11
1 Nov 2018
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Cite this article
O. Nikoubashman, D. Wischer, H.M. Hennemann, J. Sandmann, T. Sichtermann, F.S. Müschenich, A. Reich, M. Wiesmann
Balloon-Guide Catheters Are Needed for Effective Flow Reversal during Mechanical Thrombectomy
American Journal of Neuroradiology Nov 2018, 39 (11) 2077-2081; DOI: 10.3174/ajnr.A5829

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Balloon-Guide Catheters Are Needed for Effective Flow Reversal during Mechanical Thrombectomy
O. Nikoubashman, D. Wischer, H.M. Hennemann, J. Sandmann, T. Sichtermann, F.S. Müschenich, A. Reich, M. Wiesmann
American Journal of Neuroradiology Nov 2018, 39 (11) 2077-2081; DOI: 10.3174/ajnr.A5829
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  • SAVE vs. Solumbra Techniques for Thrombectomy
  • Contrast-Induced Encephalopathy after NeuroIR
  • CT Perfusion&Reperfusion in Acute Ischemic Stroke
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