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Modified BADDASS Technique for Acute Anterior Circulation Large Vessel Occlusion: A Single-Centre, Randomized
Kechun Chen1, Zhenduo Li1, Yin Zhou1
1Department of Neurology, Zhangjiagang Hospital Affiliated to Soochow University (The First People's Hospital of Zhangjiagang City), Zhangjiagang, China.
World Neurosurgery
|July 15, 2026
Summary
The modified BADDASS technique did not improve functional outcomes for acute anterior circulation large vessel occlusion (AAC-LVO) stroke patients. While it increased first-pass effect rates, this did not translate to better clinical results.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Clinical Trials
Background:
- Acute anterior circulation large vessel occlusion (AAC-LVO) is a critical condition requiring rapid reperfusion.
- Endovascular thrombectomy techniques aim to improve patient outcomes by restoring blood flow.
- The BADDASS technique is a standard approach, but modifications are being explored to enhance efficacy.
Purpose of the Study:
- To evaluate if a modified BADDASS technique improves clinical outcomes in patients with AAC-LVO compared to the standard technique.
- To assess functional independence at 90 days as the primary outcome measure.
Main Methods:
- A single-center, prospective, randomized controlled trial involving 170 patients with AAC-LVO.
- Patients were randomized to receive either the modified BADDASS technique (Embotrap III stents with partial retrieval) or the standard BADDASS technique.
- Functional independence (modified Rankin Scale score 0-2) at 90 days was the primary endpoint.
Main Results:
- The modified BADDASS technique did not significantly improve functional independence at 90 days (56% vs. 51%, P=0.40).
- However, the modified technique showed higher rates of modified first-pass effect (mFPE) (76% vs. 61%, P=0.04) and first-pass effect (FPE) (55% vs. 39%, P=0.03).
- No significant differences were found in successful reperfusion, symptomatic intracranial hemorrhage, or mortality between the groups.
Conclusions:
- The modified BADDASS technique did not demonstrate superior 90-day functional outcomes compared to the standard technique in AAC-LVO patients.
- Procedural advantages, such as increased FPE and mFPE, did not translate into improved clinical benefit.
- Further research in specific patient subgroups is warranted to explore potential benefits of the modified technique.
