ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1651156
This article is part of the Research TopicResearch on the Correlative Mechanisms and Clinical Exploration of Headache and Cerebrovascular DiseasesView all articles
Complete Anterior Circle of Willis Improves Thrombectomy Efficacy of Balloon Guide Catheter for Internal Carotid Artery Occlusion
Provisionally accepted
- Sir Run Run Shaw Hospital, School of Medicine, Graduate School, Zhejiang University, Hangzhou, China
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Introduction: With the continuous advancement of clinical techniques, the role of the balloon guide catheter (BGC) in practice has gradually diminished. However, identifying anatomical factors associated with its therapeutic efficacy remains essential. Variations in the configuration of the circle of Willis (CoW) can lead to distinct hemodynamic changes. This study aimed to evaluate the effectiveness of BGC use during anterior circulation thrombectomy across different CoW configurations. Methods: This single-center retrospective study analyzed 109 patients admitted with embolic large vessel occlusion (LVO) of the anterior circulation. A complete anterior CoW was defined as the presence of a patent anterior communicating artery (ACoA) and bilateral A1 segments. We assessed the single-pass recanalization rate, the recanalization rate within two passes, and the procedure time associated with BGC use across different anterior CoW configurations.Results: Of the 45 patients with a complete anterior CoW, this configuration was associated with a higher single-pass recanalization rate (48.9% vs. 28.1%, P = 0.027) and a shorter procedure time (58.4 min vs. 82.8 min, P = 0.005). In the subgroup analysis, the use of BGC in cases of ICA occlusion with a complete anterior CoW achieved the highest single-pass recanalization rate (61.9%) and recanalization within two passes (95.2%). Logistic regression analysis demonstrated that BGC use in ICA occlusion with a complete anterior CoW was an independent factor associated with a higher likelihood of achieving recanalization within two passes (P = 0.001).A complete anterior CoW was an independent factor associated with fewer thrombectomy passes and a shorter procedure time. For patients with ICA occlusion and a complete anterior CoW, the use of BGC was the optimal approach to improve overall thrombectomy efficacy.
Keywords: Balloon guide catheter, Thrombectomy, Circle of Willis, Acute ischemic stroke, technique
Received: 23 Jun 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Chen, Jin, Shi, Jiang, Hu, Zheng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jinhua Zhang, Sir Run Run Shaw Hospital, School of Medicine, Graduate School, Zhejiang University, Hangzhou, China
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