E-120 First pass efficacy of anterior circulation thrombectomy using the walrus balloon guide catheter

Abstract

<h3>Purpose</h3> Evaluation of the Walrus balloon guide catheter (BGC) first pass efficacy in mechanical thrombectomy cases compared to other guide catheters. <h3>Material and Methods</h3> Retrospective review of our prospectively maintained Neuro IR database and identification of all patients who underwent mechanical thrombectomy for anterior circulation strokes between January 2019 and November 2020. First pass efficacy was defined as successful single-pass mechanical thrombectomy resulting in mTICI score equal or greater than 2B. Information on number of passes needed to achieve TICI 2B or greater as well as total number of passes and final revascularization score were recorded. <h3>Results</h3> The Walrus BGC (Q’apel Medical) is a revolutionary 0.087-inch inner diameter and 0.110-inch outer diameter device specifically designed for stroke patients. Its design offers distal flexibility, great trackability and optimal proximal support. A total of 239 anterior circulation stroke cases were identified between January 2019 and November 2020. Of those, 80 cases were performed using the Walrus BGC. First pass mTICI score equal or greater than 2B was achieved in 45/80 cases (56.3%) using the Walrus BGC with 39 of those cases (86.7%) achieving mTICI 2C or 3. An mTICI score equal or greater than 2B was achieved in 77/159 cases (48.4%) using other guide catheters including the Flowgate BGC (Stryker), Cello BGC (Medtronic), Merci BGC (Stryker), Neuron Max (Penumbra) and Infinity (Stryker) with 59 of those cases (76.6%) achieving mTICI 2C or 3. mTICI 2B was not achieved in 35 cases (43.7%) in the Walrus BGC group versus 82 cases (51.6%) in the other guide catheter group. The higher first pass and final recanalization scores maybe explained by the ability to put larger ID intermediate catheters for either aspiration alone or with stent retrievers in conjunction with the Walrus BGC. <h3>Conclusion</h3> The Walrus BGC achieved more first pass mTICI scores equal or greater than 2B when compared to other guide catheters for anterior circulation mechanical thrombectomy and among those cases also achieved more mTICI 2C and 3 recanalizations. <h3>Disclosures</h3> <b>A. Kuhn:</b> None. <b>V. Naragum:</b> None. <b>J. Singh:</b> None. <b>K. de Macedo Rodrigues:</b> None. <b>F. Massari:</b> None. <b>V. Anagnostakou:</b> None. <b>M. Gounis:</b> 1; C; National Institutes of Health (NIH), the United States – Israel Binational Science Foundation, Anaconda, ApicBio, Axovant, Cerenovus, Cook Medical, Gentuity, Imperative Care, InNeuroCo, Magneto. 2; C; Cerenovus, Imperative Care, phenox, Medtronic Neurovascular, Route 92 Medical, Stryker Neurovascular. 4; C; Imperative Care, InNeuroCo and Neurogami. <b>A. Puri:</b> 1; C; NIH, Stryker Neurovascular, Medtronic, Cerenovus. 2; C; Microvention, QApel, Perfuze Medical, Arsenal Medical, Merit Medical, Stryker Neurovascular, Medtronic, Cerenovus. 4; C; InNeuroCo Inc, Galaxy therapeutics, Agile Medical, Perfuze medical and NTI.