Balloon Guide Catheter to Optimize Outcomes in Stroke Thrombectomy of the Internal Carotid Artery

Inclusion criteria

• age ≥18 years;
• Clinical diagnosis of acute ischemic stroke with internal carotid artery occlusion confirmed by imaging (CTA/MRA/DSA), including isolated intracranial internal carotid artery (I-type), internal carotid artery intracranial segment involving middle cerebral artery (L-type), or internal carotid artery intracranial segment involving middle and anterior cerebral arteries (T-type) (including tandem embolic occlusions of the internal carotid artery C1 or common carotid artery);
• Baseline NIHSS≥6, and meeting local guidelines for mechanical thrombectomy;
• Time from onset or last known normal to randomization within 24 hours and proceeding to mechanical thrombectomy;
• Signed informed consent (or by legal representative).

Exclusion criteria

• Pre-stroke mRS score >2
• Intracranial hemorrhage shown on imaging;
• Known or suspected internal carotid artery occlusion caused by dissection or atherosclerosis;
• Vascular tortuosity preventing the use of balloon guide catheter;
• Prior stent implantation in the target vessel that would impede the use or removal of mechanical thrombectomy devices;
• Any other circumstances impeding mechanical thrombectomy implementation;
• Acute occlusion of multiple vascular territories in bilateral anterior circulation or in both the anterior and posterior circulations confirmed by CTA/MRA;
• Pregnant subjects;
• Subjects allergic to contrast agents;
• Subjects refusing to cooperate or unable to tolerate interventional procedures;
• Subjects whose expected lifetime are less than 90 days;
• Midline shift or herniation with ventricular mass effect;
• Subjects deemed unable to participate in follow-up by investigators;
• Other situations deemed unsuitable for balloon guide catheter use by investigators.