Temporary flow arrest using EMBOGUARD™ balloon guide catheter may improve functional outcomes in acute stroke thrombectomy: a multicenter retrospective study.

The EMBOGUARD™ BGC group achieved comparable first-pass effect rates to the non-BGC group.

• FPE was 33.3% in the EMBOGUARD™ group versus 37.2% in the non-BGC group (p = 0.68).
• The difference was not statistically significant.
• Multivariate logistic regression showed an adjusted odds ratio of 2.01 (95% CI 0.65–6.41, p = 0.2) for FPE, which was not statistically significant.
• Total sample: 178 patients (EMBOGUARD: n = 135, 75.8%; non-BGC: n = 43, 24.2%).

Successful recanalization rates (mTICI ≥2b) were similar between the EMBOGUARD™ and non-BGC groups.

• Successful recanalization was achieved in 86.7% of the EMBOGUARD™ group versus 86.0% of the non-BGC group (p = 0.92).
• The difference was not statistically significant.
• The study included patients with anterior large vessel occlusions treated between January 2022 and December 2024.

Procedural time was significantly shorter in the EMBOGUARD™ group compared to the non-BGC group.

• Median procedural time was 32 minutes in the EMBOGUARD™ group versus 49 minutes in the non-BGC group (p = 0.004).
• This was a statistically significant difference.
• This is one of the key differentiating findings between the two approaches in this study.

Distal embolization rates were similar between the EMBOGUARD™ and non-BGC groups.

• Distal embolization occurred in 4.4% of the EMBOGUARD™ group versus 4.7% of the non-BGC group (p = 1.00).
• No statistically significant difference was observed.
• Reduced distal embolization is one of the theorized benefits of balloon guide catheters in mechanical thrombectomy.

The EMBOGUARD™ group showed significantly higher rates of favorable functional outcome at 90 days compared to the non-BGC group.

• Favorable functional outcome (mRS 0–2) at 90 days was achieved in 48.6% of the EMBOGUARD™ group versus 28.1% of the non-BGC group (p = 0.04).
• However, multivariate logistic regression did not confirm an independent association (aOR 1.36, 95% CI 0.35–5.34, p = 0.7).
• The discrepancy between unadjusted and adjusted results suggests potential confounding by baseline characteristics.

Ninety-day mortality was lower in the EMBOGUARD™ group but the difference was not statistically significant.

• Mortality at 90 days was 13.7% in the EMBOGUARD™ group versus 16.7% in the non-BGC group (p = 0.6).
• Multivariate logistic regression showed an aOR of 0.32 (95% CI 0.05–1.85, p = 0.2) for mortality, which was not statistically significant.
• The authors described this as a 'non-significantly lower' and 'favorably trending' result.

Multivariate logistic regression did not confirm independent associations between EMBOGUARD™ use and improved FPE, functional outcome, or reduced mortality.

• Adjusted OR for FPE: 2.01 (95% CI 0.65–6.41, p = 0.2).
• Adjusted OR for mRS 0–2 at 90 days: 1.36 (95% CI 0.35–5.34, p = 0.7).
• Adjusted OR for 90-day mortality: 0.32 (95% CI 0.05–1.85, p = 0.2).
• The authors noted results were 'although favorably trending' but did not reach statistical significance on adjusted analysis.

The study was a retrospective multicenter design enrolling patients with anterior large vessel occlusions treated with mechanical thrombectomy.

• 178 total patients were included across multiple centers.
• The study period was January 2022 to December 2024.
• EMBOGUARD™ is described as a 'novel design with enhanced flexibility and compatibility with large-bore aspiration catheters' manufactured by Johnson & Johnson Neurovascular.
• The non-BGC group comprised 43 patients (24.2%) and the EMBOGUARD™ group comprised 135 patients (75.8%).