Early Experience With the Dual-Mode Radial-Access Catheter Armadillo in Neuroendovascular Procedures via the Radial Approach: A Multicenter Study of 71 Patients

Abstract

BACKGROUND AND OBJECTIVES: The transradial approach is increasingly being adopted by neurointerventionalists after several studies showed its safety, efficacy, and patient satisfaction. However, the use of non–radial-specific devices for transradial procedures is a major barrier for transradial adoption. In this study, we aim to demonstrate the efficacy, technical feasibility, and safety of the Armadillo dual-mode guide catheter (Q'Apel Medical Inc.) as a radial-specific catheter in various neurovascular pathologies. METHODS: This is a multicenter retrospective study of 71 patients who underwent neurointerventional procedures via the transradial route using the Armadillo guide catheter between 2021 and 2023. RESULTS: Our study cohort comprised 71 patients, mostly females (n = 33, 63.5%) with a mean age of 59.1 ± 13.5 years. 13 (18.3%) patients underwent carotid artery stenting and angioplasty, 39 (54.9%) aneurysm treatment, 9 (12.7%) vascular malformation embolization, 5 (7.0%) tumor embolization, and 5 (7.0%) middle meningeal artery embolization for chronic subdural hematomas. The mean procedure time was 61.4 ± 33.5 min, mean fluoro time was 29.6 ± 14.4 min, and mean radiation exposure was 93.3 ± 56.3 Gy cm2. During the procedures, 70 (98.6%) target vessels were successfully catheterized. The rate of access site complications was 0%, and 1 (1.4%) patient required conversion to the transfemoral route. CONCLUSION: The use of the Armadillo catheter showed promising outcomes in terms of safety, effectiveness, and technical feasibility in various neuroendovascular procedures, demonstrating a high success rate and low morbidity rate.