Abstract
INTRODUCTION: The Zebra guide catheter (Q'Apel Medical, Inc.) offers stable navigation in neuroendovascular procedures, featuring a 0.087” inner diameter and the lowest outer profile for a 7F sheath. It is approved for both transradial and transfemoral approaches, but is distinctive in its capacity to accommodate 0.070‐0.071” distal access catheters through a 7F slender radial sheath. This unique compatibility facilitates radial‐first strategies for interventions that have traditionally required femoral access. This study reports consecutive cases where the Zebra guide catheter was used for 0.070" distal access compatibility as a prerequisite for successful intervention. METHODS: This retrospective review includes 19 consecutive patients who underwent neuroendovascular treatment with the Zebra guide catheter via transradial access between May and August 2025 at a single tertiary center. Indications were aneurysm embolization (n=8) and stroke thrombectomy (n=9). Demographics, procedural performance, and complications were assessed. RESULTS: All 19 procedures (mean age 71.5 ± 14.7 years; 10 [52.6%] female) were successfully completed using the Zebra guide catheter via radial access without the need for catheter exchange. Indications were acute ischemic stroke (n=11), unruptured aneurysm (n=5), and ruptured aneurysm (n=3). All patients had type II aortic arch anatomy. Target vessel interventions were performed in the right anterior circulation (n=11), left anterior circulation (n=6), right vertebral artery (n=1), and left vertebral artery (n=1). Diagnostic catheters were Simmons (n=14) or Berenstein (n=5). Intermediate catheters were Sofia (n=15) or Cereglide (n=4). Adjunctive devices included LVIS EVO stent (n=2), Pipeline flow diverter (n=2), and WEB device (n=1). Mean access‐to‐cervical artery time was 12.7 ± 6.1 minutes. Mean procedural time was 57.6 ± 33.0 minutes; mean fluoroscopy time was 26.5 ± 21.3 minutes; mean contrast volume was 50.5 ± 20.5 mL; and mean radiation dose was 711.4 ± 678.5 mGy. No device‐related complications, access‐site issues, readmissions, or mortality occurred. All radial arteries remained patent post‐procedure, as confirmed by nursing assessments. CONCLUSION: The 7F Zebra guide catheter uniquely combines the compatibility of a slender radial sheath with large‐bore distal catheter support, enabling the safe conversion of select transfemoral cases to a radial‐first approach. In this consecutive series, it demonstrated excellent technical success without complications, underscoring its role in expanding transradial strategies for complex neuroendovascular interventions.