BOBBY balloon guide catheter thrombectomy in large-vessel occlusion stroke: Initial experience

Area of Science:

• Neurology
• Interventional Neuroradiology
• Medical Devices

Background:

• Balloon Guide Catheters (BGC) are increasingly used in mechanical thrombectomy (MT) for ischemic stroke.
• Previous nonrandomized studies suggest BGCs improve technical and functional outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of the BOBBY Balloon Guide Catheter (BBGC) in patients undergoing MT for acute ischemic stroke.
• To assess the impact of BBGC use on first-pass effect and functional outcomes.

Main Methods:

• Retrospective analysis of prospectively collected data from ischemic stroke patients undergoing MT between December 2020 and October 2021.
• Identification of patients who received the BOBBY BGC (BBGC).
• Collection and analysis of baseline demographics, clinico-radiographic characteristics, and procedural data.

Main Results:

• 43 patients underwent BBGC-MT, with a median age of 72 years. Middle cerebral artery (MCA) occlusions were most common (60.4%).
• The BBGC navigated tortuous aortic arches effectively. Median arteriotomy-to-perfusion time was 29 minutes.
• High rates of successful reperfusion were achieved: modified TICI 3 in 74.4% and 2b/3 in 95.3% of cases.
• First-pass effect (FPE) rates were 51.1% (mTICI 3) and 79.1% (mTICI 2b/3), increasing to 92.3% and 100% when combined with stent-retriever and thromboaspiration.
• Significant reduction in NIHSS scores (median 9) and favorable 90-day mRS (median 1.5) were observed.

Conclusions:

• The BOBBY BGC is associated with a high first-pass effect rate in mechanical thrombectomy for ischemic stroke.
• BBGC use appears to contribute to improved functional outcomes in stroke patients.