Purpose: Transradial intracranial aneurysm embolization is well established, but experience with large-bore 7F sheath-based guide platforms remains comparatively limited. We evaluated the technical feasibility and periprocedural outcomes of a 7F sheath-compatible 0.087inch guide catheter for transradial intracranial aneurysm embolization.Materials and Methods: In this single-arm, noncomparative retrospective study, we reviewed consecutive patients who underwent attempted transradial intracranial aneurysm embolization using the NeuGlide as the primary guide catheter at a single center between January 2025 and May 2026. Preaccess radial ultrasonography was performed in all patients, and radial diameter ≥1.7 mm was required for 7F access. The primary outcome was completion of the intended treatment through radial access without femoral conversion.Results: Target-vessel catheterization was achieved in 71/74 procedures (95.9%), and radial procedural completion in 69/74 (93.2%; 95% confidence interval, 85.1–97.1%). Three procedures required femoral conversion, and 2 were terminated without aneurysm treatment; overall treatment completion was 72/74 (97.3%). Guide instability occurred in 2 procedures: 1 repositioning-only event and 1 event resulting in femoral conversion; no guide exchanges occurred. Seven patients had 9 access-site component events, all managed conservatively; all 6 hematomas were low-grade (EASY I–II). Radial artery occlusion was identified in 1/15 patients formally assessed.Conclusion: In this radial-first cohort, the 7F sheath-compatible 0.087-inch NeuGlide guide catheter achieved a 93.2% radial procedural completion rate across multiple intracranial aneurysm treatment strategies. These findings support the NeuGlide as a technically feasible and versatile large-bore transradial platform in appropriately selected patients.
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