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Walrus large bore guide catheter impact on recanalization first pass effect and outcomes: the WICkED study
Authors
Cortez, Gustavo M.Turner, Raymond D.
Monteiro, Andre
Puri, Ajit S
Siddiqui, Adnan H.
Mocco, J.
Vargas, Jan
Kuhn, Anna L.
Majidi, Shahram
Chaudry, M. Imran
Aghaebrahim, Amin
Turk, Aquilla S.
Sauvageau, Eric
Hanel, Ricardo A.
UMass Chan Affiliations
Department of RadiologyDocument Type
Journal ArticlePublication Date
2021-04-15Keywords
catheterdevice
stroke
thrombectomy
Cardiovascular Diseases
Equipment and Supplies
Nervous System Diseases
Neurology
Neurosurgery
Radiology
Metadata
Show full item recordAbstract
BACKGROUND: The use of a balloon-guide catheter (BGC) in acute stroke treatment has been widely adopted after demonstrating optimized procedure metrics and outcomes. Initial technical constraints of previous devices included catheter stiffness and smaller inner diameters. We aim to evaluate the performance and safety of the Walrus BGC, a variable stiffness catheter with a large bore 0.087 inch inner diameter (ID), via the the WICkED study (Walrus Large Bore guide Catheter Impact on reCanalization first pass Effect anD outcomes). METHODS: This is a retrospective, site adjudicated, multicenter study on consecutive patients with large vessel occlusion treated with the Walrus BGC. Baseline characteristics, procedural outcomes and functional outcomes were analyzed. RESULTS: A total of 338 patients met the inclusion criteria. The Walrus was successfully tracked into distal vasculature and allowed therapeutic device delivery in all but 3 cases (0.9%). Large aspiration catheters > /=0.070 inch ID were used in 71.9% of cases. Stent retriever thrombectomy was used as the first-line modality in 59.2% and thromboaspiration in 40.8% of cases. The successful recanalization rate (modified treatment in cerebral ischemia (mTICI) 2b/3) was 94.4%, with 64.8% of the patients achieving mTICI 2b/3 after the first pass. The Walrus-related adverse event rate was 0.6%, corresponding to two vessel dissections. Functional independence was 50% (126/252) and mortality 25% (63/252). Unfavorable outcomes were more likely in older patients, who had unsuccessful reperfusion, longer procedure times, and a higher mean number of passes. CONCLUSION: In acute ischemic stroke patients presenting with large vessel occlusion, the Walrus BGC demonstrated excellent navigability and safety profile, allowed the accommodation of leading large bore aspiration catheters, and demonstrated high vessel recanalization rates.Source
Cortez GM, Turner RD, Monteiro A, Puri AS, Siddiqui AH, Mocco J, Vargas J, Kuhn AL, Majidi S, Chaudry MI, Aghaebrahim A, Turk AS, Sauvageau E, Hanel RA. Walrus large bore guide catheter impact on recanalization first pass effect and outcomes: the WICkED study. J Neurointerv Surg. 2021 Apr 15:neurintsurg-2021-017494. doi: 10.1136/neurintsurg-2021-017494. Epub ahead of print. PMID: 33858971. Link to article on publisher's site
DOI
10.1136/neurintsurg-2021-017494Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48531PubMed ID
33858971Related Resources
ae974a485f413a2113503eed53cd6c53
10.1136/neurintsurg-2021-017494