Joanna M Roy, Meah T Ahmed, Kareem El Naamani, Nazanin Saadat, Wendell Gaskins, Alyssa Nguyen, Maimuna Gigo, Antony A Fuleihan, Cheritesh Amaravadi, Arbaz Momin, Basel Musmar, Stavropoula I Tjoumakaris, M Reid Gooch, Robert H Rosenwasser, Pascal M Jabbour
{"title":"经桡动脉与经股动脉入路诊断性脑血管造影的程序结果（根据体重指数）：倾向评分匹配分析。","authors":"Joanna M Roy, Meah T Ahmed, Kareem El Naamani, Nazanin Saadat, Wendell Gaskins, Alyssa Nguyen, Maimuna Gigo, Antony A Fuleihan, Cheritesh Amaravadi, Arbaz Momin, Basel Musmar, Stavropoula I Tjoumakaris, M Reid Gooch, Robert H Rosenwasser, Pascal M Jabbour","doi":"10.3171/2024.7.JNS241183","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>BMI has been shown to affect choice of access site in coronary intervention procedures, with lower complications reported during transradial (TR) access. To the authors' knowledge, the effect of BMI on outcomes in patients undergoing diagnostic cerebral angiography remains undescribed. This study compares outcomes for BMI subgroups based on access site (TR vs transfemoral [TF] access).</p><p><strong>Methods: </strong>The authors conducted a single-center retrospective study of patients who underwent diagnostic cerebral angiography between December 2019 and January 2024. Propensity score matching was used to create two similar cohorts (TR and TF). These cohorts were subdivided based on BMI: underweight (BMI < 18.5), normal (BMI 18.5-25.0), overweight (BMI 25.1-29.9), and obese (BMI ≥ 30). Linear regression analysis and the chi-square test were used to compare outcomes.</p><p><strong>Results: </strong>Nine hundred thirty-six patients were stratified into two groups of 468 patients each. Procedure time was significantly shorter for TR access for all BMI subgroups, with a 13-minute reduction in procedure time among underweight patients. Patients with normal BMI, overweight patients, and obese patients experienced a reduction in procedure time of approximately 11, 10, and 13 minutes, respectively. Obese patients experienced significantly shorter length of stay (LOS; 1.33 days) with TR access. There were no significant differences between each BMI subgroup in access site complications, postoperative complications, and conversion of access from TR to TF.</p><p><strong>Conclusions: </strong>TR access in diagnostic cerebral angiography is associated with shorter procedure times and no increased risk of complications compared to TF access across all BMI subgroups. Obese patients experienced shorter LOS with TR access. This study adds to the literature on the safety and efficacy of TR access across all BMI subgroups. Further studies are necessary to validate these preliminary results.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-7"},"PeriodicalIF":3.5000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Procedural outcomes of the transradial versus transfemoral approach for diagnostic cerebral angiograms according to BMI: a propensity score-matched analysis.\",\"authors\":\"Joanna M Roy, Meah T Ahmed, Kareem El Naamani, Nazanin Saadat, Wendell Gaskins, Alyssa Nguyen, Maimuna Gigo, Antony A Fuleihan, Cheritesh Amaravadi, Arbaz Momin, Basel Musmar, Stavropoula I Tjoumakaris, M Reid Gooch, Robert H Rosenwasser, Pascal M Jabbour\",\"doi\":\"10.3171/2024.7.JNS241183\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>BMI has been shown to affect choice of access site in coronary intervention procedures, with lower complications reported during transradial (TR) access. To the authors' knowledge, the effect of BMI on outcomes in patients undergoing diagnostic cerebral angiography remains undescribed. This study compares outcomes for BMI subgroups based on access site (TR vs transfemoral [TF] access).</p><p><strong>Methods: </strong>The authors conducted a single-center retrospective study of patients who underwent diagnostic cerebral angiography between December 2019 and January 2024. Propensity score matching was used to create two similar cohorts (TR and TF). These cohorts were subdivided based on BMI: underweight (BMI < 18.5), normal (BMI 18.5-25.0), overweight (BMI 25.1-29.9), and obese (BMI ≥ 30). Linear regression analysis and the chi-square test were used to compare outcomes.</p><p><strong>Results: </strong>Nine hundred thirty-six patients were stratified into two groups of 468 patients each. Procedure time was significantly shorter for TR access for all BMI subgroups, with a 13-minute reduction in procedure time among underweight patients. Patients with normal BMI, overweight patients, and obese patients experienced a reduction in procedure time of approximately 11, 10, and 13 minutes, respectively. Obese patients experienced significantly shorter length of stay (LOS; 1.33 days) with TR access. There were no significant differences between each BMI subgroup in access site complications, postoperative complications, and conversion of access from TR to TF.</p><p><strong>Conclusions: </strong>TR access in diagnostic cerebral angiography is associated with shorter procedure times and no increased risk of complications compared to TF access across all BMI subgroups. Obese patients experienced shorter LOS with TR access. This study adds to the literature on the safety and efficacy of TR access across all BMI subgroups. Further studies are necessary to validate these preliminary results.</p>\",\"PeriodicalId\":16505,\"journal\":{\"name\":\"Journal of neurosurgery\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-11-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3171/2024.7.JNS241183\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3171/2024.7.JNS241183","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Procedural outcomes of the transradial versus transfemoral approach for diagnostic cerebral angiograms according to BMI: a propensity score-matched analysis.
Objective: BMI has been shown to affect choice of access site in coronary intervention procedures, with lower complications reported during transradial (TR) access. To the authors' knowledge, the effect of BMI on outcomes in patients undergoing diagnostic cerebral angiography remains undescribed. This study compares outcomes for BMI subgroups based on access site (TR vs transfemoral [TF] access).
Methods: The authors conducted a single-center retrospective study of patients who underwent diagnostic cerebral angiography between December 2019 and January 2024. Propensity score matching was used to create two similar cohorts (TR and TF). These cohorts were subdivided based on BMI: underweight (BMI < 18.5), normal (BMI 18.5-25.0), overweight (BMI 25.1-29.9), and obese (BMI ≥ 30). Linear regression analysis and the chi-square test were used to compare outcomes.
Results: Nine hundred thirty-six patients were stratified into two groups of 468 patients each. Procedure time was significantly shorter for TR access for all BMI subgroups, with a 13-minute reduction in procedure time among underweight patients. Patients with normal BMI, overweight patients, and obese patients experienced a reduction in procedure time of approximately 11, 10, and 13 minutes, respectively. Obese patients experienced significantly shorter length of stay (LOS; 1.33 days) with TR access. There were no significant differences between each BMI subgroup in access site complications, postoperative complications, and conversion of access from TR to TF.
Conclusions: TR access in diagnostic cerebral angiography is associated with shorter procedure times and no increased risk of complications compared to TF access across all BMI subgroups. Obese patients experienced shorter LOS with TR access. This study adds to the literature on the safety and efficacy of TR access across all BMI subgroups. Further studies are necessary to validate these preliminary results.
期刊介绍：
The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.
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