The initial experience with the Walrus balloon guide catheter – Results from two high-volume thrombectomy centres

TY - JOUR

T1 - The initial experience with the Walrus balloon guide catheter – Results from two high-volume thrombectomy centres

AU - Bhogal, Pervinder

AU - Dhillon, Permesh Singh

AU - Flood, Richard

AU - Lewis, Martin

AU - Podlasek, Anna

AU - Wong, Ken

AU - Lansley, Joseph

AU - Makalanda, Levansri

AU - Minks, David

AU - Spooner, Oliver

AU - Mortimer, Alex

N1 - Publisher Copyright: © The Author(s) 2025.

PY - 2025/5/21

Y1 - 2025/5/21

N2 - Background: We report our initial experience on the use of the Walrus, a new generation balloon guide catheter (BGC) capable of accommodating large bore aspiration catheters for patients undergoing endovascular stroke thrombectomy for large vessel occlusion with a particular focus on procedural aspects related to the vascular anatomy, recanalisation efficacy and complications. Methods: This is a retrospective, site-adjudicated, two-centre study on consecutive patients with anterior circulation large vessel occlusion treated with the Walrus BGC. Baseline characteristics and procedural and clinical outcomes were analysed. Results: Between July 2023 and January 2024, we recruited 300 participants (mean age 69.5 ± 15 years; 132 (44%) females). The mean admission NIHSS was 15.8 ± 6.5, and the mean ASPECTS was 7.6 ± 1.9. Combined stent-retriever and aspiration first-line thrombectomy technique was performed in 235 patients (79%). The Walrus BGC was successfully navigated to the ICA in 99.7% of patients. Near complete–complete recanalisation (eTICI2c-3) was achieved in 75.4% of patients, and the eTICI2b-3 rate was 92.2%. First-pass effect (eTICI2c-3) was achieved in 49% of patients, and the modified first-pass effect (eTICI2b-3) was 65.9%. No significant difference in the arterial puncture-to-guide catheter placement time across the three different arch types (P =.52) or between the favourable and unfavourable ASMETS score (P =.085) was observed. Any intracranial haemorrhage (ICH) occurred in 14.9% of patients, and symptomatic ICH in 3.9%. Conclusion: Use of the Walrus large bore BGC during endovascular stroke thrombectomy appears effective in reaching the target vessel without a significant time penalty across various anatomical configurations and tortuosity, whilst maintaining a satisfactory safety profile.

AB - Background: We report our initial experience on the use of the Walrus, a new generation balloon guide catheter (BGC) capable of accommodating large bore aspiration catheters for patients undergoing endovascular stroke thrombectomy for large vessel occlusion with a particular focus on procedural aspects related to the vascular anatomy, recanalisation efficacy and complications. Methods: This is a retrospective, site-adjudicated, two-centre study on consecutive patients with anterior circulation large vessel occlusion treated with the Walrus BGC. Baseline characteristics and procedural and clinical outcomes were analysed. Results: Between July 2023 and January 2024, we recruited 300 participants (mean age 69.5 ± 15 years; 132 (44%) females). The mean admission NIHSS was 15.8 ± 6.5, and the mean ASPECTS was 7.6 ± 1.9. Combined stent-retriever and aspiration first-line thrombectomy technique was performed in 235 patients (79%). The Walrus BGC was successfully navigated to the ICA in 99.7% of patients. Near complete–complete recanalisation (eTICI2c-3) was achieved in 75.4% of patients, and the eTICI2b-3 rate was 92.2%. First-pass effect (eTICI2c-3) was achieved in 49% of patients, and the modified first-pass effect (eTICI2b-3) was 65.9%. No significant difference in the arterial puncture-to-guide catheter placement time across the three different arch types (P =.52) or between the favourable and unfavourable ASMETS score (P =.085) was observed. Any intracranial haemorrhage (ICH) occurred in 14.9% of patients, and symptomatic ICH in 3.9%. Conclusion: Use of the Walrus large bore BGC during endovascular stroke thrombectomy appears effective in reaching the target vessel without a significant time penalty across various anatomical configurations and tortuosity, whilst maintaining a satisfactory safety profile.

KW - balloon guide catheter

KW - endovascular

KW - Stroke

KW - thrombectomy

UR - https://www.scopus.com/pages/publications/105005858414

U2 - 10.1177/15910199251336935

DO - 10.1177/15910199251336935

M3 - Article

C2 - 40398475

AN - SCOPUS:105005858414

SN - 1591-0199

JO - Interventional Neuroradiology

JF - Interventional Neuroradiology

M1 - 15910199251336935

ER -