Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach

Abstract Background and purpose To determine the risk factors for puncture-related complications after the distal transradial approach (dTRA) for cerebrovascular angiography and neuroendovascular intervention and to explore the incidence and potential mechanisms of procedural failure and puncture-re...

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Main Authors: Weikai Wang, Yonggang Ma, Chao Wang, Peng Shi, Weibo Lv, Guangliang Fan, Chao Sun
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-024-03940-5
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author Weikai Wang
Yonggang Ma
Chao Wang
Peng Shi
Weibo Lv
Guangliang Fan
Chao Sun
author_facet Weikai Wang
Yonggang Ma
Chao Wang
Peng Shi
Weibo Lv
Guangliang Fan
Chao Sun
author_sort Weikai Wang
collection DOAJ
description Abstract Background and purpose To determine the risk factors for puncture-related complications after the distal transradial approach (dTRA) for cerebrovascular angiography and neuroendovascular intervention and to explore the incidence and potential mechanisms of procedural failure and puncture-related complications. Materials and methods From February to November 2023, 62 patients underwent dTRA in our department. Demographic, clinical, and procedural data were collected retrospectively. Postoperative puncture-related complications were defined as a syndrome of major hematoma, minor hematoma, arterial spasm/occlusion, arteriovenous fistula, pseudoaneurysm, and neuropathy. Univariate and multivariate logistic regressions were performed to identify significant factors contributing to puncture-related complications. Results Forty-five diagnostic cerebral angiograms and 17 neurointerventions were performed or attempted with dTRA in 62 patients. Procedural success was achieved via dTRA in 47 (75.8%) patients, whereas 15 (24.2%) required conversion to other approaches. Reasons for failure included puncture failure (n = 8), inability to cannulate due to arterial spasm (n = 6), and inadequate catheter support of the left vertebral artery (n = 1). 17.0% (8/47) of patients had postoperative puncture-related complications. Minor hematoma occurred in 8.5% (4/47) of patients, arterial spasm/occlusion in 6.3% (3/47), and neuropathy in 2.1% (1/47). No major complications were observed. On stepwise multivariable regression analysis, BMI (OR = 0.70, 95%CI 0.513 to 0.958; p = 0.026) was an independent risk factor for puncture-related complications, with a cut-off of 24.8 kg/m2 (sensitivity 66.7% and specificity 87.5%). Conclusion Our cohort is the first study of risk factors for puncture-related complications after neurointerventional interventions with dTRA. This study has shown that a low BMI (< 24.8 kg/m2) is independently associated with the development of puncture-related complications.
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spelling doaj-art-fc23595c6b2b4b8bb11e0818b92072a22024-11-10T12:30:58ZengBMCBMC Neurology1471-23772024-11-0124111310.1186/s12883-024-03940-5Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approachWeikai Wang0Yonggang Ma1Chao Wang2Peng Shi3Weibo Lv4Guangliang Fan5Chao Sun6Department of Neurosurgery, Binzhou Medical University HospitalDepartment of Neurosurgery, Binzhou Medical University HospitalDepartment of Neurosurgery, Binzhou Medical University HospitalDepartment of Neurosurgery, Binzhou Medical University HospitalDepartment of Neurosurgery, Binzhou Medical University HospitalDepartment of Neurosurgery, Binzhou Medical University HospitalDepartment of Endocrinology, Binzhou Medical University HospitalAbstract Background and purpose To determine the risk factors for puncture-related complications after the distal transradial approach (dTRA) for cerebrovascular angiography and neuroendovascular intervention and to explore the incidence and potential mechanisms of procedural failure and puncture-related complications. Materials and methods From February to November 2023, 62 patients underwent dTRA in our department. Demographic, clinical, and procedural data were collected retrospectively. Postoperative puncture-related complications were defined as a syndrome of major hematoma, minor hematoma, arterial spasm/occlusion, arteriovenous fistula, pseudoaneurysm, and neuropathy. Univariate and multivariate logistic regressions were performed to identify significant factors contributing to puncture-related complications. Results Forty-five diagnostic cerebral angiograms and 17 neurointerventions were performed or attempted with dTRA in 62 patients. Procedural success was achieved via dTRA in 47 (75.8%) patients, whereas 15 (24.2%) required conversion to other approaches. Reasons for failure included puncture failure (n = 8), inability to cannulate due to arterial spasm (n = 6), and inadequate catheter support of the left vertebral artery (n = 1). 17.0% (8/47) of patients had postoperative puncture-related complications. Minor hematoma occurred in 8.5% (4/47) of patients, arterial spasm/occlusion in 6.3% (3/47), and neuropathy in 2.1% (1/47). No major complications were observed. On stepwise multivariable regression analysis, BMI (OR = 0.70, 95%CI 0.513 to 0.958; p = 0.026) was an independent risk factor for puncture-related complications, with a cut-off of 24.8 kg/m2 (sensitivity 66.7% and specificity 87.5%). Conclusion Our cohort is the first study of risk factors for puncture-related complications after neurointerventional interventions with dTRA. This study has shown that a low BMI (< 24.8 kg/m2) is independently associated with the development of puncture-related complications.https://doi.org/10.1186/s12883-024-03940-5Distal transradial approachRisk factorsComplicationsDiagnostic cerebral angiography
spellingShingle Weikai Wang
Yonggang Ma
Chao Wang
Peng Shi
Weibo Lv
Guangliang Fan
Chao Sun
Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach
BMC Neurology
Distal transradial approach
Risk factors
Complications
Diagnostic cerebral angiography
title Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach
title_full Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach
title_fullStr Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach
title_full_unstemmed Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach
title_short Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach
title_sort risk factors for puncture related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach
topic Distal transradial approach
Risk factors
Complications
Diagnostic cerebral angiography
url https://doi.org/10.1186/s12883-024-03940-5
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