Radial artery occlusion after aneurysm treatment using the rist guide catheter: Single center cohort study

Area of Science:

• Interventional Neuroradiology
• Vascular Surgery
• Neuroendovascular Procedures

Background:

• Delayed radial artery occlusion (dRAO) is a common complication following transradial access (TRA) in neurointervention, particularly with large guide catheters.
• The RIST 079 guide catheter (RIST GC) represents a novel device specifically engineered for TRA in neurointerventional procedures.

Purpose of the Study:

• To evaluate the incidence of dRAO after intracranial aneurysm (IA) treatment utilizing the RIST GC via TRA.
• To identify potential risk factors associated with dRAO in this patient cohort.

Main Methods:

• A prospective study involving 22 patients who underwent IA treatment using TRA and the RIST GC between June 2021 and November 2022.
• Systematic US-Doppler assessment of radial artery patency was performed at a 3-month follow-up to detect dRAO.
• Comparative analysis was conducted between patients with and without dRAO to determine risk factors.

Main Results:

• At 3-month follow-up, 6 out of 22 patients (27.3%) exhibited dRAO.
• Among those with dRAO, 4 were asymptomatic, while 2 experienced radial hematoma and wrist pain.
• A trend towards younger age, longer procedure duration, and increased forearm hematoma was observed in patients with dRAO.
• Successful navigation with the RIST GC was achieved in 90.9% of cases; complications were linked to left internal carotid artery navigation.

Conclusions:

• The study found a 27.3% rate of dRAO at 3-month follow-up in patients treated for IA using TRA with the RIST GC.
• While the RIST GC demonstrated high navigation success, dRAO remains a significant concern requiring further investigation and potential mitigation strategies.