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

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY BMC Neurology Pub Date : 2024-11-06 DOI:10.1186/s12883-024-03940-5
Weikai Wang, Yonggang Ma, Chao Wang, Peng Shi, Weibo Lv, Guangliang Fan, Chao Sun
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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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经桡动脉远端入路脑血管造影术和神经内血管介入术后穿刺相关并发症的风险因素。
背景和目的:确定经桡动脉远端入路(dTRA)脑血管造影和神经内血管介入术后穿刺相关并发症的风险因素,探讨手术失败和穿刺相关并发症的发生率和潜在机制:2023年2月至11月,62名患者在我科接受了dTRA手术。回顾性收集了人口统计学、临床和手术数据。术后穿刺相关并发症定义为大血肿、小血肿、动脉痉挛/闭塞、动静脉瘘、假性动脉瘤和神经病变综合征。研究人员进行了单变量和多变量逻辑回归,以确定导致穿刺相关并发症的重要因素:对62名患者进行或尝试使用dTRA进行了45次诊断性脑血管造影和17次神经介入治疗。47名患者(75.8%)通过dTRA获得了手术成功,15名患者(24.2%)需要转用其他方法。失败原因包括穿刺失败(8 例)、动脉痉挛导致无法插管(6 例)以及左侧椎动脉导管支持不足(1 例)。17.0%(8/47)的患者出现了术后穿刺相关并发症。8.5%(47 例中有 4 例)的患者出现轻微血肿,6.3%(47 例中有 3 例)的患者出现动脉痉挛/闭塞,2.1%(47 例中有 1 例)的患者出现神经病变。没有观察到重大并发症。在逐步多变量回归分析中,体重指数(OR = 0.70,95%CI 0.513 至 0.958;P = 0.026)是穿刺相关并发症的独立风险因素,临界值为 24.8 kg/m2(灵敏度为 66.7%,特异度为 87.5%):我们的队列是首次对使用 dTRA 进行神经介入治疗后出现穿刺相关并发症的风险因素进行研究。这项研究表明,低体重指数(2)与穿刺相关并发症的发生有独立关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
期刊最新文献
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