{ "abstract": "Introduction/Purpose Superbore guide catheters have become increasingly adopted in mechanical thrombectomy for acute ischemic stroke. The Zoom/TracStar 0.088’ platforms represent a newer and widely adopted iteration of these access systems and are noted for their ability to provide distal intracranial access and cervical stability. We aimed to compare procedural and angiographic outcomes between Zoom/TracStar superbore guide catheters and conventional guide catheters in a propensity-matched cohort at our single-center.Materials and Methods We retrospectively evaluated patients undergoing mechanical thrombectomy for ischemic stroke at our comprehensive stroke center between January 2019 and October 2024. Patients were divided into two groups: those treated with Zoom/TracStar superbore catheters (Zoom 88, Zoom 88 Support, Zoom RDL, TracStar LDP) and those treated with other prior-generation guide catheters. Patients were propensity score matched one-to-one using nearest neighbor matching with a caliper of 0.2, adjusting for covariates including age, NIHSS at presentation, occluded vessel, and last-known-well to puncture time. Outcomes included procedural times (puncture-to-first-pass, puncture-to-max-reperfusion, fluoroscopy time), contrast volume used, number of passes, modified first-pass effect (mFPE), successful reperfusion (mTICI ≥2b), and periprocedural complications. Data are presented as Zoom/TracStar vs other unless otherwise specified.Results A total of 264 patients were included following propensity score matching (132 per cohort). Covariates were adequately balanced after matching, with all Standard Mean Differences (SMDs) <0.2 except for NIHSS (SMD = 0.21). NIHSS at presentation was higher in the Zoom/TracStar cohort (17.57 ± 7.04 vs 16.05 ± 7.09), though this difference was not statistically significant (p = 0.08). Mean puncture-to-first-pass time was significantly shorter in the Zoom/TracStar cohort (18.11 ± 10.54 vs 21.74 ± 13.55 minutes, p = 0.021), as was puncture-to-max-reperfusion time (28.36 ± 17.99 vs 34.98 ± 22.04 minutes, p = 0.013). Contrast volume (48.69 ± 27.06 vs 57.14 ± 31.12 mL, p = 0.021) and fluoroscopy time (18.45 ± 15.23 vs 22.54 ± 15.69 minutes, p = 0.033) were also significantly lower in the Zoom/TracStar cohort. The mean number of passes was similar between groups (2.27 ± 1.36 vs 2.09 ± 1.34, p = 0.216). Modified first-pass effect occurred more frequently in the Zoom/TracStar cohort, though this did not reach statistical significance (50.8% vs 39.4%, p = 0.083). Rates of final successful mTICI ≥2b reperfusion (90.2% vs 88.6%, p = 0.842) were comparable between groups. There were no significant differences in complications, including intraoperative vasospasm requiring verapamil (7.6% vs 10.6%, p = 0.521), distal embolization to new territories (1.5% vs 3.0%, p = 0.684), catheter-related dissection (2.3% vs 2.3%, p > 0.999), wrist/groin hematoma (7.6% vs 6.1%, p = 0.808), or 90-day mortality (27.3% vs 32.6%, p = 0.420).Conclusion In this single-center propensity-matched cohort, use of Zoom/TracStar superbore guide catheters was associated with significantly improved procedural efficiency, including shorter time to first pass and maximal reperfusion, reduced fluoroscopy time, and lower contrast utilization, with otherwise comparable reperfusion rates and safety outcomes. A possible trend toward improved first-pass success was also observed. These findings support the safety and potential procedural advantages of Zoom/TracStar catheter use in mechanical thrombectomy.Disclosures J. Delikat: None. J. Kallarackal: None. A. Patel: None. E. Pressman: None. K. Yeganeh: None. E. Sargent: None. A. Letavay: None. F. Klocksieben: None. W. Guerrero: None. M. Mokin: 2; C; Medtronic, Imperative Care, Balt USA, Microvention, Rapid Pulse. K. Vakharia: 2; C; Medtronic, Terumo Neuro, Phenox Wallaby, Stryker, Microvention, Imperative Care.", "authors": [ { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "J Delikat" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "J Kallarackal" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "A Patel" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "E Pressman" }, { "affiliations": [ "Ponce Health Sciences University, Ponce, PR" ], "name": "K Yeganeh" }, { "affiliations": [ "Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL" ], "name": "E Sargent" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "A Letavay" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "F Klocksieben" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "W Guerrero" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "M Mokin" }, { "affiliations": [ "Department of Neurosurgery, Brain, and Spine, University of South Florida Morsani College of Medicine, Tampa, FL" ], "name": "K Vakharia" } ], "title": "E-345 Procedural efficiency and outcomes with zoom/tracstar superbore guide catheters in mechanical thrombectomy: a propensity-matched cohort study", "uid": "d2a64c59-c96d-5be2-a813-5fad25f91e81" }