First experience with Walrus balloon guide catheter in a whole-body flow model

Area of Science:

• Neuroendovascular intervention
• Cerebrovascular diseases
• Medical device technology

Background:

• Mechanical thrombectomy (MT) for large vessel occlusion (LVO) stroke improves outcomes.
• Balloon guide catheters (BGCs) are crucial for flow arrest during MT.
• Existing BGCs have limitations including incompatibility with large bore aspiration catheters (AC) and reduced distal flexibility.

Purpose of the Study:

• To evaluate the first experience with the Walrus BGC in a realistic stroke simulation model.
• To assess the Walrus BGC's compatibility with large bore ACs.
• To determine the Walrus BGC's navigability and distal access capabilities.

Main Methods:

• A full-length modular vascular model under physiological conditions was utilized.
• The Walrus BGC (8F+, 0.087in ID, 95cm) was tested with a 6F Sofia AC (0.070in ID, 131cm).
• Comparisons were made with an 8F Flowgate2 BGC (0.084in ID, 95cm) and a 5F Sofia AC (0.055in ID, 125cm).
• Assessments included user surveys, access to target/occlusion sites, technique, delivery time, anatomical changes, and catheter kick-back.

Main Results:

• All seven neuroradiologists reported high likelihood of reusing the Walrus BGC with large bore ACs (29% likely, 71% very likely).
• The majority (86%) found the Walrus BGC easier to navigate compared to other BGCs.
• The Walrus BGC demonstrated significantly better access to the internal carotid artery (ICA) petrous segment and intracranial occlusions (p<0.05 and p<0.01, respectively).

Conclusions:

• The Walrus BGC, when combined with large bore ACs, offers superior distal access and navigability for primary aspiration in an in vitro stroke model.
• This new BGC technology shows promise for improving mechanical thrombectomy procedures in acute ischemic stroke.