Radial-specific catheters for neuroendovascular procedures: A systematic review and meta-analysis

Background: Despite a radial-first approach in many neurointerventions, there are no systematic reviews and meta-analysis which comprehensively assess radial-specific catheter for neuroendovascular procedures. A systematic literature search was conducted through four electronic databases based on PRISMA 2020 guideline. Risk of bias was assessed employing Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. A total of eleven studies with 990 patients using Armadillo, RIST, Zoom RDL, and BMX 81 catheters were included. The Armadillo showed significantly lower failure to catheterize the target vessel (0.0% vs. 3.04%, P = 0.036) than RIST. The Zoom RDL catheter had relatively higher failure rate of 10.3%. There was no significant difference between the Armadillo and RIST catheters in procedure-related complications. There were no reported cases of arterial spasm or hemorrhage for Armadillo catheter. RIST catheter had a 3.2% rate of neurological complications, a 3.1% rate of transfemoral conversion, and a 1.8% rate of hematoma. The BMX 81 catheter had a 2.5% rate of arterial vasospasm and a 5% rate of procedure-related complications. The Zoom RDL catheter had consistent rates of procedure-related, transfemoral conversion, and neurological complications, all at 6.9%, with insufficient data on other complications.