Feasibility and safety of the non-radial-specific 6 Fr FUBUKI XF guiding sheath for transradial neuroendovascular procedures

The transradial approach (TRA) is gaining popularity in neuroendovascular therapy due to its safety and patient comfort, but its application in emergency settings with complex vascular anatomy remains technically demanding. This study assessed the feasibility and safety of using the 6 Fr FUBUKI XF long guiding sheath—a non-radial-specific device—for neuroendovascular procedures via TRA. Nineteen consecutive patients treated with the FUBUKI XF long guiding sheath between April 2024 and June 2025 were retrospectively reviewed and compared with a small cohort treated using the radial-specific Rist guiding sheath during the same period. The FUBUKI XF cohort had a mean age of 70.2 years, and 57.9 % were female. Most procedures (73.7 %) were for ruptured aneurysms. Anatomical challenges included type III aortic arch and aberrant right subclavian artery. Technical access success was achieved in 94.7 % of cases, with one case converted to transfemoral access. Median procedure time was 111.0 min (IQR, 72.0), median fluoroscopy time was 54.0 min (IQR, 35.3), and median DAP was 153.0 Gy·m² (IQR, 46.0). Intermediate catheters were employed in 94.7 % of procedures. One case of carotid dissection required stenting, but no major access-site complications occurred. The FUBUKI XF sheath’s atraumatic tip, flexible shaft, and high trackability enabled effective navigation and support. These findings suggest that the FUBUKI XF is a feasible and safe option for TRA-based neurointerventions, with performance comparable to radial-specific devices in complex anatomical scenarios.