Aristotle wires for cannulating target vessels in paediatric neuro-interventional procedures: A case-control study.

Background: Paediatric neuro-interventional (PNI) procedures are markedly different to adult procedures and are more likely to be complicated by vasospasm. Traversing the complex tortuous anatomy in these fragile vessels requires both torque control and distal tip softness of the microwire. The Aristotle wires (Scientia Vascular Inc) are a new family of wires with design features offering both torque control and distal tip softness. We sought to assess the ability of these wires to achieve successful target vessel cannulation in paediatric patients.

Methods: The study design was a single-centre case-control study. We compared a case cohort of PNI procedures performed using the Aristotle wires (2023-24) with a control cohort using other wires (2022-23). The primary study outcome was successful cannulation of the target vessel (Yes/No) with a microcatheter.

Results: The Aristotle wires cohort consisted of 44 targeted vessels across 40 procedures in 20 patients (F = 8; mean age 6.9, SD 6.53 years). The other wires cohort consisted of 41 targeted vessels across 41 procedures in 19 patients (F = 6; mean age 4.3, SD 4.98 years). Successful cannulation of the target vessel was achieved in 43 of 44 target vessels (97.7%) in the Aristotle wires cohort and 34 of 41 target vessels (82.9%) in the other wires cohort (p = .020). The rate of wire-related complications was significantly lower in the Aristotle wires cohort (0 of 44 vs 6 of 41 target vessels, p = .008).

Conclusion: Aristotle wires were associated with significantly better target vessel cannulation and lower wire-related complications than other wires in PNI procedures.