{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:11:16Z","timestamp":1787497876738,"version":"build-2736575974"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between July 2023 and January 2024, we recruited 300 participants (mean age 69.5\u2009\u00b1\u200915 years; 132 (44%) females). The mean admission NIHSS was 15.8\u2009\u00b1\u20096.5, and the mean ASPECTS was 7.6\u2009\u00b1\u20091.9. 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\u2013complete 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 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.52) or between the favourable and unfavourable ASMETS score (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.085) was observed. Any intracranial haemorrhage (ICH) occurred in 14.9% of patients, and symptomatic ICH in 3.9%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251336935","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T19:02:29Z","timestamp":1747854149000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The initial experience with the Walrus balloon guide catheter \u2013 Results from two high-volume thrombectomy centres"],"prefix":"10.1177","author":[{"given":"Pervinder","family":"Bhogal","sequence":"first","affiliation":[{"name":"Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4353-4515","authenticated-orcid":false,"given":"Permesh Singh","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Radiological Sciences, Mental Health &amp; Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Interventional Neuroradiology, Gold Coast University Hospital, Gold Coast, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Flood","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7297-7169","authenticated-orcid":false,"given":"Anna","family":"Podlasek","sequence":"additional","affiliation":[{"name":"Radiological Sciences, Mental Health &amp; Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Tayside Innovation Medtech Ecosystem (TIME), University of Dundee, Dundee, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Lansley","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6637-9293","authenticated-orcid":false,"given":"Levansri","family":"Makalanda","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Minks","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Spooner","sequence":"additional","affiliation":[{"name":"Department of Stroke Medicine, Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7744-2833","authenticated-orcid":false,"given":"Alex","family":"Mortimer","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199221142097"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1591019920938223"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199221135309"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.12.075"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2019.0114"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002407"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015150575"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021126"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.6.JNS181045"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024723"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2019.05.032"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012319"},{"key":"e_1_3_2_14_2","first-page":"200","article-title":"Predictors of difficult carotid stenting as determined by aortic arch angiography","volume":"20","author":"Madhwal S","year":"2008","unstructured":"Madhwal S, Rajagopal V, Bhatt DL, et al. 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