An Institutional Analysis of the Versatility of the Zebra Catheter in Transradial and Transulnar Neurointerventions
Umair Ahmed1, Alyssa Evans1, Victoria Lamberti1, Jeffrey Katz4, Jonathan Scheiner2, Raphael Sacho3, James Lee1
1Neurology, 2Radiology, 3Neurosurgery, Staten Island University Hospital, 4North Shore University Hospital
Objective:
Performance of zebra-catheter in trans-radial and trans-ulnar neuroendovascular procedures
Background:
Optimal support during neuroendovascular interventions is paramount to ensuring technical precision and favorable outcomes. Guide catheters are essential to this paradigm, as they provide stability to the system construct and navigability. One promising catheter, the Zebra (Q’Apel Medical), is a new neurovascular access catheter that features a large-bore inner-diameter (.074” and .087”) without necessitating a significantly larger outer-diameter. Given its availability in 6F and 7F profiles, this design innovation has allowed for increased procedural versatility, especially for trans-radial (TRA)/trans-ulnar (TUA) approaches. Herein, we present our institutional experience with the Zebra-catheter, highlighting its resourcefulness and adaptability in various moderate-to-high-complexity procedures.
Design/Methods:
A retrospective database was generated from patients that underwent neuroendovascular interventions between January-2025 till July-2025, for which the Zebra-catheter was utilized, after evaluation for suitability for TRA or TUA. Important variables collected including patient demographics, procedure type, access site, catheter specifics, implanted devices, and complications.
Results:
Thirteen patients underwent neurointerventions with the Zebra-catheter during the study period. TRA was used in 12-patients, and TUA was used in 1-patient. The 7F Zebra-catheter was used for all cases. The primary interventions included carotid-angioplasty with stenting (n=7), flow-diverter for aneurysms (n=2), thrombectomies (n=2), aneurysmal coiling (n=1), and venous-sinus stenting (n=1). All procedures were successfully completed with no major periprocedural or postprocedural complications noted. In one case, several days post-procedure, a patient developed a small infarct in the setting of hypotension with no long-term sequelae.
Conclusions:
Our experience with the Zebra-catheter highlights its safety and versatility for use in a variety of complex cases. The design of the catheter, which optimizes the inner working diameter for intervention, and 6F/7F profile, provides an exciting addition to the armamentarium, especially for TRA and TUA procedures. Further larger studies will be critical to identify the strengths and limitations of the catheter.
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