The Era of Radial-Specific Catheters: A Multicenter Comparison of the Armadillo and RIST Catheters in Transradial Procedures

Kareem El Naamani; Joanna M Roy; Arbaz A Momin; Eric M Teichner; Georgios S Sioutas; Mohamed M Salem; Wendell Gaskins; Nazanin Saadat; Alyssa Mai Nguyen; Stavropoula I Tjoumakaris; M Reid Gooch; Robert H Rosenwasser; Visish Srinivasan; Brian T Jankowitz; Jan-Karl Burkhardt; Pascal M Jabbour

doi:10.1227/ons.0000000000001256

The Era of Radial-Specific Catheters: A Multicenter Comparison of the Armadillo and RIST Catheters in Transradial Procedures

Oper Neurosurg (Hagerstown). 2024 Jul 5. doi: 10.1227/ons.0000000000001256. Online ahead of print.

Authors

Kareem El Naamani¹, Joanna M Roy¹, Arbaz A Momin¹, Eric M Teichner¹, Georgios S Sioutas², Mohamed M Salem², Wendell Gaskins¹, Nazanin Saadat¹, Alyssa Mai Nguyen¹, Stavropoula I Tjoumakaris¹, M Reid Gooch¹, Robert H Rosenwasser¹, Visish Srinivasan², Brian T Jankowitz², Jan-Karl Burkhardt², Pascal M Jabbour¹

Affiliations

¹ Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
² Department of Neurological Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

PMID: 38967427
DOI: 10.1227/ons.0000000000001256

Abstract

Background and objectives: As the radial approach is gaining popularity in neurointervention, new radial-specific catheters are being manufactured while taking into consideration the smaller size of the radial artery, different trajectories of angles into the great vessels from the arm, and subsequent force vectors. We compared outcomes of transradial procedures performed using the Armadillo catheter (Q'Apel Medical Inc.) and the RIST radial guide catheter (Medtronic).

Methods: This is a retrospective multicenter study comparing outcomes of transradial neuroendovascular procedures using the Armadillo and RIST catheters at 2 institutions between 2021 and 2024.

Results: The study comprised 206 patients, 96 of whom underwent procedures using the Armadillo and 110 using the RIST. Age and sex were comparable across cohorts. In most procedures, 1 target vessel was catheterized (Armadillo: 94.8% vs 89.1%, P = .29) with no significant difference between cohorts. The use of an intermediate catheter was minimal in both cohorts (Armadillo 5.2% vs RIST: 2.7%, P = .36), and the median number of major vessel catheterization did not significantly differ between cohorts (Armadillo: 1 [1-4] vs RIST: 1 [0-6], P = .21). Failure to catheterize the target vessel was encountered in 1 case in each cohort (Armadillo: 1.0% vs RIST: 0.9%, P = .18), and the rate did not significantly differ between cohorts. Similarly, the rate of conversion to femoral access was comparable between cohorts (Armadillo: 2.1% vs RIST: 1.8%, P = .55). There was no significant difference in access site complications (Armadillo: 1% vs RIST: 2.8%, P = .55) or neurological complications (Armadillo: 3.1% vs RIST: 5.5%, P = .42) between cohorts.

Conclusion: No significant difference in successful catheterization of target vessels, procedure duration, triaxial system use, complication rates, or the need for transfemoral cross-over was observed between both catheters. Both devices offer high and comparable rates of technical success and low morbidity rates.