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New devices and techniques
Case series
The Rist radial access system: a multicenter study of 152 patients
  1. Isaac Josh Abecassis1,
  2. Vasu Saini2,
  3. R Webster Crowley3,
  4. Stephan A Munich3,
  5. Justin Singer4,
  6. Joshua W Osbun5,
  7. Bradley A Gross6,
  8. Brian P Walcott7,
  9. Todd R Peebles8,
  10. Mark Bain9,
  11. Christopher M Storey10,
  12. Dileep R Yavagal2,
  13. Robert M Starke1,
  14. Eric C Peterson1
  1. 1 Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
  2. 2 Neurology, University of Miami, Miami, Florida, USA
  3. 3 Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA
  4. 4 Neurosurgery, Spectrum Health Michigan State University College of Human Medicine Internal Medicine Residency Program, Grand Rapids, Michigan, USA
  5. 5 Neurosurgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
  6. 6 Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  7. 7 Neurological Surgery, Northshore University Health System & University of Chicago, Evanston, IL, USA
  8. 8 Radiology Associates of the Fox Valley, Neenah, Wisconsin, USA
  9. 9 Neurological Surgery, Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA
  10. 10 Nashville Neurosurgery Associates, Nashville, Tennessee, USA
  1. Correspondence to Dr Isaac Josh Abecassis, University of Miami Miller School of Medicine, Miami, FL 33136-1015, USA; jabecassis{at}mac.com

Abstract

Background Transradial access (TRA) for neurointervention is becoming increasingly popular as experience with the technique grows. Despite reasonable efficacy using femoral catheters off-label, conversion to femoral access occurs in approximately 8.6–10.3% of TRA cases, due to an inability of the catheter to track into the vessel of interest, lack of support, or radial artery spasm.

Methods This is a multicenter, retrospective case series of patients undergoing neurointerventions using the Rist Radial Access System. We also present our institutional protocol for using the system.

Results 152 patients were included in the cohort. The most common procedure was flow diversion (28.3%). The smallest radial diameter utilized was 1.9 mm, and 44.1% were performed without an intermediate catheter. A majority of cases (96.1%) were completed successfully; 3 (1.9%) required conversion to a different radial catheter, 2 (1.3%) required conversion to femoral access, and 1 (0.7%) was aborted. There was 1 (0.7%) minor access site complication and 4 (2.6%) neurological complications.

Conclusions The Rist catheter is a safe and effective tool for a wide range of complex neurointerventions, with lower conversion rates than classically reported.

  • angiography
  • catheter
  • device
  • intervention
  • technology

https://doi.org/10.1136/neurintsurg-2021-017739

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    Footnotes

    • Twitter @drjoshabecassis, @brianwalcottMD, @trpeebles, @Starke_neurosurgery

    • Contributors Conception and design: IJA, ECP. Acquisition, analysis, and interpretation of data: IJA, VS, RWC, SAM, JS, JWO, BAG, BPW, TRP, MB, CMS, DRY, RMS, ECP. Drafting manuscript: IJA, ECP. Critically revising manuscript: IJA, VS, RWC, SAM, JS, JWO, BAG, BPW, TRP, MB, CMS, DRY, RMS, ECP. Final approval: IJA, VS, RWC, SAM, JS, JWO, BAG, BPW, TRP, MB, CMS, DRY, RMS, ECP.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests IJA – Remedy Robotics: Consultant, Equity. In Neuro Co.: Consultant. VS – In Neuro Co.: Consultant. RWC – Medtronic: Consultant/Proctor, Cerenovus: Consultant/Proctor, Microvention: Consultant/Proctor. SAM – None. JS – Medtronic: Honoraria, Consultant. Stryker: Honoraria, Consultant. Cerenovus: Honoraria. Penumbra: Honoraria. Nico Corp: Honoraria. Imperative Care: Advisory Board.JWO – Medtronic: Consultant. Terumo: Consultant. Microvention: Consultant. In Neuro Co.: Consultant. BAG – Microvention: Consultant. Medtronic: Consultant. BPW – None. TRP – Medtronic: Consultant, Teaching, Shareholder (prior shareholder with RIST Neurovascular). Penumbra: Consultant, Teaching. Terumo: Consultant, Teaching. MB – Medtronic: Consultant. CS – Medtronic: Consultant. Vaselio: Equity. DRY – Medtronic: Personal fees. Cerenovus: Personal fees. Rapid Medical: Personal fees. Vascular Dynamics: Personal fees. Poseydon: Other. Neurosave: Other. Neuralanalytics: Other. RMS – Research is supported: NREF, Joe Niekro Foundation, Brain Aneurysm Foundation, Bee Foundation, and National Institute of Health (R01NS111119-01A1) and (UL1TR002736, KL2TR002737) through the Miami Clinical and Translational Science Institute, from the National Center for Advancing Translational Sciences and the National Institute on Minority Health and Health Disparities. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Medtronic: Unrestricted research grant, Consulting, Teaching Agreement. Penumbra: Consulting, Teaching Agreement. Abbott: Consulting, Teaching Agreement. InNeuroCo: Consulting, Teaching Agreement. Cerenovus: Consulting, Teaching Agreement. ECP – Stryker: Consultant. Penumbra: Consultant. Medtronic: Consultant, Royalty payments (specifically in relation to the RIST system). Cerenovus: Consultant. Contributorship Statement – Conception and design: IJA, ECP. Acquisition, analysis, and interpretation of data: IJA, VS, RWC, SAM, JS, JWO, BAG, BPW, TRP, MB, CMS, DRY, RMS, ECP. Drafting manuscript: IJA, ECP. Critically revising manuscript: IJA, VS, RWC, SAM, JS, JWO, BAG, BPW, TRP, MB, CMS, DRY, RMS, ECP. Final approval: IJA, VS, RWC, SAM, JS, JWO, BAG, BPW, TRP, MB, CMS, DRY, RMS, ECP.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.