Procedural outcomes of the transradial versus transfemoral approach for diagnostic cerebral angiograms according to BMI: a propensity score-matched analysis.

IF 3.5 2区 医学 Q1 CLINICAL NEUROLOGY
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
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引用次数: 0

Abstract

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.

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。
目的:研究表明,体重指数(BMI)会影响冠状动脉介入手术入路部位的选择,经桡动脉(TR)入路的并发症较低。据作者所知,BMI 对接受诊断性脑血管造影术的患者预后的影响仍未得到描述。本研究根据入路部位(TR 与经股动脉 [TF] 入路)比较了 BMI 亚组的预后:作者对 2019 年 12 月至 2024 年 1 月期间接受诊断性脑血管造影术的患者进行了一项单中心回顾性研究。采用倾向评分匹配法创建了两个相似的队列(TR 和 TF)。这些队列根据体重指数进行了细分:体重不足(体重指数<18.5)、正常(体重指数18.5-25.0)、超重(体重指数25.1-29.9)和肥胖(体重指数≥30)。采用线性回归分析和卡方检验比较结果:936 名患者被分为两组,每组 468 人。所有 BMI 亚组的 TR 入路手术时间都明显缩短,体重不足的患者手术时间缩短了 13 分钟。体重指数正常患者、超重患者和肥胖患者的手术时间分别缩短了约 11 分钟、10 分钟和 13 分钟。肥胖患者使用 TR 入路的住院时间(LOS;1.33 天)明显缩短。在入路部位并发症、术后并发症以及从 TR 入路转为 TF 入路方面,各 BMI 亚组之间没有明显差异:结论:在诊断性脑血管造影术中,TR入路与TF入路相比,手术时间更短,并发症风险也不增加。肥胖患者使用TR入路的手术时间更短。这项研究为所有 BMI 亚组中 TR 入路的安全性和有效性提供了更多文献资料。要验证这些初步结果,还需要进一步的研究。
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
Journal of neurosurgery
Journal of neurosurgery 医学-临床神经学
CiteScore
7.20
自引率
7.30%
发文量
1003
审稿时长
1 months
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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