Eric Peterson

Endovascular Neurosurgeon

[Eric Peterson @braincutter]

Congrats to @DavidTrewern and the team at @fliteboard on their recent acquisition by Brunswick. Ever since I bought my fliteboard 3 years ago, I’ve been telling people it’s the best piece of tech I’ve ever owned. Nothing else even comes close!

#efoil

https://t.co/FvQGMB3wAx

[Eric Peterson @braincutter]

Used to say left vert interventions should be done by left radial. Very tough to get an interventional setup into distal left VA from a right radial approach

Until RIST!

#RadialFirst

[Medtronic Neurovascular @Medtronic_NV]

Join us on November 2nd as we host a Radial Access Round-Table with Dr. Eric Peterson, MD. @braincutter

Register Here: https://t.co/EtLTvrkJ4H
Risk Info: https://t.co/Xks7i3H0rQ

[Marios Psychogios @MPeyT1]

Use of the 🆕 RIST system for #radialfirst tx of a cerebral aneurysm‼️ The flexibility of the distal part allows for easy navigation to the cavernous segment. Here, in the treatment of a pcom aneurysm with a🕸 device @braincutter @Starkeneurosurg
#RIST #radial4neuro #aneurysm

[jack @jackbutcher]

if everyone understands what you're doing, you're late

[Eric Peterson @braincutter]

@sudhakar_satti @AjitSPuri1 @JOsbunMDxCV @alex_spiotta @PascalJabbourMD @JanKarlBurkhar1 @shamsherdalal @VenuVadlamudiMD @dyavagal Strongly disagree. Radial is super elastic and we haven’t measure in years. All the low RAO rates (<5%) even with 7F sheaths are because the sheath is coated. All that goes out the window with sheathless technique. We routinely place 7F sheaths in radial arteries <2mm.

[Eric Peterson @braincutter]

Wow. I usually teach that if you run into Lusoria you should convert to femoral.

But I guess that’s only true if you are using femoral tools!

It seems that now that we have the RIST system that advice is outdated

Amazing case

#RadialFirst

[Barts Health Interventional Neuroradiology @RLHINR]

Next gen @Medtronic #RIST #TRA catheters make navigating difficult arches easy. PED placed through this vascular ring of an aberrant right subclavian with a rock solid platform. Great to have this kit in the UK for our patients @hldmak @Aggour @drpaulbhogal @klw88888

[Eric Peterson @braincutter]

Want to kick back in Vegas while I spoon feed you how to do radial access?

It’s going to cost you...oh wait no. It’s FREE.

Fellows and attendings welcome!

#RadialFirst

Click here to register:

https://t.co/9Ojrw2higX

[Michael Levitt, MD @DrMichaelLevitt]

Learn radial neuroangiography #RadialForNeuro from two of the OGs: @braincutter and @PascalJabbourMD - this book has everything you need including basic and advanced techniques. https://t.co/sdFM2nOqxR

[Cuong Nguyen @CuongNguyenMD]

Our first radial pipeline with RIST catheter. Trackable and stable system for pipeline. Kudos to Eric Peterson ⁦⁦@braincutter⁩ and his team for designing this awesome radial specific neuro catheter. ⁦@sudhakar_satti⁩ ⁦@MeckRad⁩ ⁦@NovantHealth⁩

[Eric Peterson @braincutter]

Radial for Neuro just keeps getting more & more undeniable

-Patients prefer it
-Lower morbidity
-Lower hospital stay
-Lower costs @JNIS_BMJ

This isn't going to go away guys

How much longer are you going to wait to convert your practice?

#RadialFirst
https://t.co/eQLydONVvQ

[Eric Peterson @braincutter]

Agreed. I don’t have a PhD @JMDaviesMDPhD so there is just only so much insight my primitive brain can muster!

[Jason Davies, MD,PhD @JMDaviesMDPhD]

@braincutter @OmarChoudhri Dr @braincutter, as usual you've oversimplified. The list is as follows:
#RightRadialFirst
#RightUlnarSecond
#LeftRadialThird
#LeftUlnarFourth
...

#OnlyThenFemoral
#NeverBrachial

Didn't even broach the subject of distal radial...
So many _good_ options to avoid the groin.

[Eric Peterson @braincutter]

Super important point by @OmarChoudhri

Data on ulnar is good and is a great option for loops or small radials

Especially for stroke you should just stick the biggest artery

#RadialFirst
#UlnarSecond
#FemoralThird

#NeverBrachial

[Jason Davies, MD,PhD @JMDaviesMDPhD]

@OmarChoudhri @braincutter @SandeepNathanMD @PennNSG @PennMedicine Ulnar is a great option when radial isn’t straightforward. Another tool in the toolbox to get the job done

[Eric Peterson @braincutter]

Awesome. I had someone tell me once that only people that aren’t good at femoral do radial.

Hilarious on so many levels

Also embarrassing that they just don’t care — at all — about the patient experience. Just what is easy for themselves.

#RadialFirst

[Marios Psychogios @MPeyT1]

Any reason you still puncture the groin or neck when doing venous stuff? not really right? #cubitalfirst transvenous embolization of an ethmoidal dAVF, check our vid ==> https://t.co/bBNLFUj09T <== @DrPatchiz @Fie0815 @mobilestroke4U @braincutter @VladoKZg

[Eric Peterson @braincutter]

Obesity + bilateral iliac occlusions

Presents with right T occlusion & basilar occlusion NIH 22

If you don’t know how to do radial this guy dies

Right radial 088 Infinity

Clean RICA

Then across the arch (RVA diminutive of course) to do basilar via LVA

Not easy

#RadialFirst

[Eric Peterson @braincutter]

CCF dx at OSH with femoral angio. As always, patient not pleased with experience.

Good thing the repair doesn’t need any groin access!

Radial artery + cubital vein super easy

Both IPS occluded, ready to direct stick but was an easy burrow with the 038 DAC

#RadialFirst

[Eric Peterson @braincutter]

@ikeafonso1 Luis this problem has been solved.

Long radial sheath. Merit 23cm dropped our crossover rate due to RAS to zero.

Never GA just conscious sedation.

See my prior post on this topic last week!

#RadialFirst

[Luís H Castro-Afonso @ikeafonso1]

@timbo_phillips @NeuroRadialist @RadialFirstBot @jildazz @braincutter @VladoKZg @SalomaoChodraui @AdamArthurMD @eytanraz @WBrinjikji @DrPatchiz I would also do it if I had an anesthesist all the time in the angio. The most of transitions from TR to TF access I had were due to spasm in women <40y, Even using hydrophilic caths.

[Eric Peterson @braincutter]

The routine use of long radial sheaths has been a game changer for us

Can place up to 7F 23cm sheath without a prob in most patients

Parks you in brachial

Basically eliminates spasm bc the radial artery is protected

Here is how to do it:

https://t.co/HnJhVTiZZR

#RadialFirst

[Eric Peterson @braincutter]

Landmark paper in @JNIS_BMJ:

Large multicenter study on Pipeline showing radial has not only lower access site complications but lower BRAIN complications than femoral

There is nowhere to hide guys. This is how FD should be done.

#RadialFirst

https://t.co/wCuEKOGrSi

[Eric Peterson @braincutter]

6F flow radial flow diversion is just painful

Here radial is 2mm, too small to jam 088 in sheathless

Need 6F guide instead ➡️ no 058 Navien, only phenom plus fits which just isn’t enough. Here I have it to M1 & still can’t get pipe up➡️femoral😡

#RadialFirst
#NeedBetterTools