The Rist radial access system: a multicenter study of 152 patients

Abstract

BackgroundTransradial 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.MethodsThis 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.Results152 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.ConclusionsThe Rist catheter is a safe and effective tool for a wide range of complex neurointerventions, with lower conversion rates than classically reported.

A review of technological innovations leading to modern endovascular brain aneurysm treatment

“…These device-level innovations have been accompanied by other advances that have improved the safety and efficacy of endovascular brain aneurysm treatment. Alternate access to the intracranial circulation using transradial approaches have become favored by many operators compared to conventional transfemoral approaches ( 118 ). Novel microcatheters and microwires have enabled operators to catheterize distal vascular territories that were previously inaccessible ( 119 ).…”

Rist Guide Catheter for Endovascular Procedures: Initial Case Series from a Single Center

“…The Rist 079 radial access guide catheter is the first device specifically designed for TRA neurointervention with, allegedly, the transition zones optimized for selective catheterization and tracking of high cervical ICAs. 10 Nevertheless, whether the transition zones of the Rist are superior to those in transfemoral catheters being used for radial access remains to be determined in comparative studies.…”

“…Our use of an intermediate catheter was less frequent than that in a recent multicenter experience with the Rist, in which an intermediate catheter was used in 44.1% cases. 10 When proximal support was needed, we were able to advance the Rist guide catheter into the petrous and cavernous segments of the internal carotid artery.…”

Evolution of Transradial Access for Mechanical Thrombectomy—A Single Center Experience

“…The transitions of the guide catheter are designed specifically to enhance delivery of the catheter into the great vessels from the radial artery. 7 Introduction of a catheter designed specifically for TRA had a statistically significant positive impact on contrast media utilization, procedure time, fluoroscopy time, puncture-torecanalization time, and TICI ≥ 2b recanalization rate. Although not statistically significant, there were fewer transitions to TFA in following the introduction of the Rist catheter.…”

“…[1][2][3][4][5] The attractiveness of TRA lies primarily in its safety profile and reduction in access site complications compared with TFA. 6,7 However, TRA for neurointerventional procedures is not without its limitations. The smaller caliber of the radial artery compared with the femoral artery may necessitate smaller access sheaths and smaller catheters.…”