Initial multicenter experience with the Broadway System for direct aspiration of large vessel occlusions in acute ischemic stroke

Background Aspiration catheters that feature larger calibers improve mechanical thrombectomy (MT) efficacies and outcomes. The Broadway System is a fully integrated catheter platform engineered for super-large bore access to M1. This multicenter study details the early clinical experience with the Broadway System as a first-line device for direct-aspiration thrombectomy. Methods We conducted a retrospective analysis of consecutive cases across four comprehensive stroke centers. Patient characteristics and pre-procedural stroke data were recorded. Primary outcomes were rates of successful reperfusion, defined as mTICI ≥ 2B, and first-pass efficacy (FPE). Efficiency metrics included the time to initial contact with the occlusion site and the procedural time from puncture to final recanalization. Safety outcomes included procedure-related complications, occurrence of distal embolization, and incidence of symptomatic intracerebral hemorrhage (sICH). Functional outcomes were assessed by the mRS and change in NIHSS at discharge. Results Thirty-seven patients (40.5% female) were treated with MT. The Broadway 8 catheter successfully engaged the target occlusion in 91.9% of cases, with a median time from puncture to contact with the thrombus of 10.5 min. Effective recanalization was achieved in 97.1% of cases, with 44.1% FPE. Median time from puncture to final recanalization was 21 min. The median presenting NIHSS was 16, with an improvement of 6 points at discharge. There was a 10.8% incidence of sICH. Conclusion In this initial patient cohort, the Broadway System appears to be safe and effective when used for aspiration thrombectomy. Further studies are warranted to determine specific niche roles best suited for this catheter suite.