Growing interest in optimizing endovascular thrombectomy (EVT) procedural techniques led to advancements in catheter technology and thrombectomy devices. Balloon guide catheters (BGC) facilitate proximal flow arrest and have demonstrated improved revascularization and functional outcomes.

72 patients were identified. 56.94% were female, and the median age was 73 years [IQR 66.5-83]. The majority (88.9%) had middle cerebral artery (MCA) occlusion, with a median ASPECTS score of 9 [IQR 7-10]. Approximately 26.39% of patients received intravenous thrombolytics. Successful recanalization (mTICI 2b/3) was achieved in 98.61% (71/72) of cases, while complete recanalization (TICI 2c/3) occurred in 76.39% (55/72), with a median of 1 pass (IQR 1-2). FPE and modified-FPE were achieved in 48.61% and 56.94% of cases, respectively. The median NIHSS improved significantly from 17 (IQR 11-21) at baseline to 4 (IQR 1-12) at discharge. Symptomatic intracranial hemorrhage occurred in only 1 case (1.39%). At 90 days, functional independence (mRS 0-2) was achieved in 37.5%, favorable outcomes (mRS 0-3) in 57.14%, and mortality occurred in 25% of patients.

The Emboguard BGC showed promising results, demonstrating high rates of first-pass effect (FPE) and improved recanalization rates, all while maintaining a favorable safety profile. Prospective comparative studies are needed to validate these findings and further establish its efficacy in clinical practice.