Paragon
Balloon Guide Catheter Feedback
Case Information
Physician Name
*
Institution
*
Specialty
Case Date
*
Equipment Used
Paragon Used
85cm
95cm
Diagnostic Cath
Yes
No
Short Sheath
Yes
No
Aspiration Catheter
Yes
No
Case Details
Clot Location
ICA
M1
M2
Posterior
Other
BGC Location
CCA
Cervical ICA
Prox Petrous ICA
Distal Petrous ICA
Other
Final TICI Assessment
TICI 2B
TICI 2C
TICI 3
Other
Current Preferred BGC + Size
Performance Rating
Balloon Prep
Much Worse
1
2
3
4
5
Much Better
Much Worse
Much Better
Navigability
Much Worse
1
2
3
4
5
Much Better
Much Worse
Much Better
Balloon Visibility
Much Worse
1
2
3
4
5
Much Better
Much Worse
Much Better
Stability/Support
Much Worse
1
2
3
4
5
Much Better
Much Worse
Much Better
Inflation/Deflation Speed
Much Worse
1
2
3
4
5
Much Better
Much Worse
Much Better
Overall Impression
Much Worse
1
2
3
4
5
Much Better
Much Worse
Much Better
Comments
Is this a product complaint?
Yes
No
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