Versatility of the Zebra Catheter in Transradial and Transulnar Neurointerventions

Introduction Optimal support during neuroendovascular interventions is paramount to ensuring technical precision and favorable outcomes. Guide catheters, in particular, are essential to this paradigm, as they provide stability to the system construct and navigability for difficult neuroanatomy. Continued innovations in catheter design have helped propel advances in treatment options. One promising catheter, the Zebra (Q’Apel Medical; Fremont, CA), 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. Initial analyses suggest that the Zebra access catheter is a viable option for a multitude of neuroendovascular procedures. Herein, we present our institutional experience with the Zebra access catheter, highlighting its resourcefulness and adaptability in various moderate‐to‐high‐complexity procedures. Methods A retrospective Excel database was generated on an encrypted and password‐protected computer of patients from within our metropolitan tertiary care hospital with comprehensive stroke center, who underwent neuroendovascular interventions between January 2025 till July 2025, for which the Zebra access catheter was utilized, after evaluation for suitability for TRA or TUA by ultrasound visualization and measurement of vessel diameter. Important variables collected including patient demographics, procedure type, access site, catheter specifics, implanted devices, and complications. Results A total of thirteen patients were identified who underwent neurointerventions with the Zebra access catheter during the study period. The predominant portion of cases were completed via TRA (n=12) with TUA (n=1) utilized for the other. The 7F Zebra catheter was used for all cases. The primary interventions included carotid angioplasty with stenting (n=7), flow‐diverter embolization for intracranial aneurysms (n=2), mechanical thrombectomies (n=2), aneurysmal coil embolization (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 access catheter highlights its safety and versatility for use in a variety of complex neuroendovascular 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 studies will be critical to identify the strengths and limitations of the catheter in a larger array of treated patients.