Complicaciones locales e intracraneales derivadas de la arteriografía cerebral

Mònica Serrano Clerencia , Almudena Sánchez-Gómez , Anna Grau Giner , Laura Cardete Morales , Sergi Amaro Delgado
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Abstract

Background

Although cerebral angiography is the reference technique for the diagnosis and treatment of cerebrovascular diseases, it is not without complications.

Objectives

To determine the incidence and risk factors of complications derived from therapeutic cerebral angiography (TCA), as well as to assess the risk factors associated with the appearance of local and intracranial complications.

Methodology

Retrospective cross-sectional study on TCAs carried out in 2018 on admission to the Stroke Unit of the Hospital Clínic de Barcelona. The study was approved by the centre's ethics committee. Demographic, clinical, analytical, and procedure-derived variables were collected. All patients older than 18 years undergoing TCA were included. Patients undergoing diagnostic cerebral arteriography and/or with a hospital stay less than 24 hours were excluded. The Mann-Whitney U test was used for the comparison of quantitative variables and Pearson's χ2 test for the qualitative variables.

Results

Complications were frequent, occurring in almost half of the sample (44%). A longer duration of arteriography was associated with an increase in local complications (p = .005). Intracranial complications occurred in 33% of the patients who underwent mechanical thrombectomy and were associated with older age (p = .012), stent use (associated or not with aspiration) (p = .003), and complete recanalization (p = .02), as well as having a worse functional status at discharge (p = .006).

Conclusions

Complications derived from ACT are frequent. Their importance and incidence must be known to detect those subjects at higher risk for developing them due to their functional implications and increased hospital stay.

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脑动脉造影引起的局部和颅内并发症
背景脑血管造影是诊断和治疗脑血管疾病的参考技术,但也并非没有并发症。目的确定治疗性脑血管造影(TCA)并发症的发生率和危险因素,并评估与局部和颅内并发症出现相关的危险因素。方法2018年在巴塞罗那Clínic医院中风科入院时对TCAs进行的回顾性横断面研究。该研究得到了该中心伦理委员会的批准。收集人口统计学、临床、分析和手术衍生的变量。所有18岁以上接受TCA的患者都包括在内。排除接受诊断性脑动脉造影和/或住院时间少于24小时的患者。Mann-Whitney U检验用于定量变量的比较,Pearsonχ2检验用于定性变量的比较。结果并发症发生率高,几乎有一半(44%)的患者出现并发症。动脉造影持续时间较长与局部并发症增加有关(p=0.005)。33%接受机械血栓切除术的患者出现颅内并发症,这些并发症与年龄较大(p=0.012)、支架使用(与抽吸相关或不与抽吸相关)(p=0.003)和完全再通(p=0.02)有关,以及出院时功能状态较差(p=0.006)。结论ACT并发症多发。必须了解它们的重要性和发病率,才能发现那些因其功能影响和住院时间增加而患上它们的风险更高的受试者。
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