Comparative Effectiveness of Zoom 88 and Walrus BGC in Mechanical Thrombectomy

Introduction The Zoom™ 88 guide catheters are engineered for enhanced distal access within intracranial anatomy, enabling more efficient navigation to the thrombus and improving procedural control while reducing the risk of clot fragmentation and distal embolization during endovascular stroke interventions. The Walrus Balloon Guide Catheter (BGC) has consistently demonstrated efficacy in improving thrombectomy technical success and procedural outcomes, achieving high rates of recanalization. We compared angiographic and clinical outcomes in patients undergoing mechanical thrombectomy using either the BGC or the Zoom 88 guide catheter to assess the relative superiority, inferiority, or equivalence of these approaches. Materials/Methods We conducted a retrospective review of our institutional thrombectomy database to identify adults with anterior circulation non‐tandem occlusions and baseline mRS 0‐2 who underwent MT. Multivariate regression was used to identify patient and presentation‐related confounders, which were then balanced using propensity score matching (PSM) to enable comparison of final recanalization and clinical outcomes. Results A total of 163 patients treated with BGC and 24 with Zoom 88 were included. Following propensity score matching, 23 patients per group were analyzed with balanced demographics, comorbidities, and stroke presentations (Table 1). While final TICI 2B‐2 and TICI 2C‐3 rates were comparable before and after matching, the Zoom 88 group demonstrated significantly shorter times to achieve TICI 2B‐3 (33.3±17.8 vs. 19.9±14.2 minutes, p=0.052) and TICI 2C‐3 (35.5±17.6 vs. 21.3±15.6 minutes, p=0.046). Intraparenchymal hemorrhage occurred more frequently in the BGC cohort (43.5% vs. 13%, p=0.022), though no significant differences were observed in hemorrhage subtypes. Conclusion The Zoom 88 system offers comparable thrombectomy efficacy with a significantly faster time to recanalization. Compared to BGC, it is associated with a more favorable complication profile, supporting the emerging trend toward the use of large‐bore guide catheters in mechanical thrombectomy.