Initial clinical experience with the paragon balloon guide catheter in mechanical thrombectomy: a multicenter comparative study.

This study aimed to assess the efficacy of the Paragon balloon guide catheter (BGC) in mechanical thrombectomy (MT) for large vessel occlusion (LVO). We conducted a retrospective review of patients who underwent MT for LVO between October 2023 and September 2025. Patients were categorized into two groups: those treated with the Paragon BGC (n = 41) and those treated with other BGCs (n = 83). Baseline characteristics and procedural outcomes were compared between the two groups, followed by a 1:1 propensity score matching (PSM) analysis. Multivariable analyses with odds ratio (OR) and 95% confidence interval (CI) were performed to evaluate the predictive factors for first pass effect (FPE). The Paragon group exhibited a significantly higher rate of distal BGC tip placement compared to the other BGC group (53.7% vs. 8.4%; P = 0.001). The Paragon group had higher rates of FPE (58.5% vs. 48.2%; P = 0.014). The rate of aspiration catheter delivery failure was also lower in Paragon group (14.6% vs. 26.5%; P = 0.010). In PSM analysis, Paragon group showed a higher rate of distal BGC tip placement (54.0% vs. 10.8%) and higher rates of FPE (59.5% vs. 48.6%, P = 0.042). The use of Paragon BGC (OR 1.36, 95% CI 1.24-2.48; P = 0.033) and distal BGC tip location (OR 1.48, 95% CI 1.32-2.98; P = 0.021) were identified as independent predictors of FPE. Our findings suggest that the Paragon BGC is associated with high procedural efficiency in MT for LVO.