The impact of access site on procedure time and post-anesthesia care unit (PACU) time in patients undergoing outpatient diagnostic angiograms: A propensity-score matched analysis stratified by body mass index
Joanna M. Roy , Shady Mina , Anand Kaul , Stephanie Hage , Shiv Patil , Basel Musmar , Stavropoula I. Tjoumakaris , Michael R. Gooch , Robert H. Rosenwasser , Pascal M. Jabbour
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Abstract
Background and objectives
Body mass index (BMI) is a modifiable risk factor that has been shown to affect outcomes in neurointervention. The impact of BMI on choice of access site (transradial access (TRA) or transfemoral access (TFA), remains undescribed to our knowledge. Our study analyzes outcomes of TRA and TFA stratified by BMI in patients undergoing diagnostic cerebral angiograms in an outpatient setting.
Methods
This was a retrospective analysis of a prospectively maintained database of patients who underwent diagnostic cerebral angiograms at a single institution from January 2018–2024. Propensity scores were calculated using a 1:1 optimal match method based on significant covariates derived from a logistic regression model. Patients were grouped into 2 cohorts based on access site (TRA and TFA) and stratified into BMI subgroups: (underweight (BMI <18.5), normal weight (BMI 18.5–25.0), overweight (BMI 25.0–29.9) and obese (BMI >30). Linear regression analysis and chi-square test was used to compare procedure time and post-anesthesia care unit (PACU) time across cohorts.
Results
678 patients were grouped into 2 cohorts (TRA and TFA) of 339 each. The average age of the cohort was 58 years, and 82.4 % was female. TRA significantly shortened procedure times in patients across normal and overweight subgroups of BMI compared to TFA. TRA shortened PACU times across all BMI subgroups compared to TFA. There was no significant association between access site complications or post-operative complications for TRA or TRF across BMI subgroups.
Conclusion
TRA is a safe and feasible alternative to TFA in certain subgroups of patients undergoing elective diagnostic angiogram in the outpatient setting. This is evidenced by shorter procedure time across certain BMI subgroups and shorter recovery time in the PACU across all BMI subgroups.
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Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.
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