Photo Credit: GERARD JULIEN

The following is a summary of “Risk factors for puncture-related complications after cerebrovascular angiography and neuroendovascular intervention with distal transradial approach,” published in the November 2024 issue of Neurology by Wang et al.    

The distal transradial approach (dTRA) for cerebrovascular angiography and neuroendovascular intervention is a newer technique with advantages but presents unique risks of puncture-related complications.  

Researchers conducted a retrospective study to identify factors contributing to puncture-related complications following cerebrovascular angiography and neuroendovascular intervention with dTRA.  

They reviewed data from 62 patients who underwent dTRA from February to November 2023. Puncture-related complications were classified as major or minor hematoma, arterial spasm or occlusion, arteriovenous fistula, pseudoaneurysm, and neuropathy. Both univariate and multivariate logistic regressions were used to identify significant risk factors.  

The results showed 62 patients, 45 diagnostic cerebral angiograms and 17 neurointerventions were performed with dTRA. Procedural success was achieved in 47 patients (75.8%), while 15 (24.2%) required a different approach due to puncture failure (n = 8), arterial spasm (n = 6), or inadequate catheter support of the left vertebral artery (n = 1). Among the 47 successful dTRA cases, 17.0% (8/47) had puncture-related complications, minor hematoma occurred in 8.5% (4/47), arterial spasm or occlusion in 6.3% (3/47), and neuropathy in 2.1% (1/47), no major complications were reported. Multivariable analysis identified a lower body mass index (BMI < 24.8 kg/m²) as an independent risk factor for complications (OR= 0.70, 95% CI 0.513–0.958; P=0.026), with 66.7% sensitivity and 87.5% specificity.  

They concluded that lower BMI was independently associated with increased puncture-related complications in patients undergoing dTRA for neuroendovascular interventions.  

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03940-5