Puncture artery steno-occlusion after transradial and transulnar neurointervention: incidence, predictors, and follow-up outcomes.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-08-01 Epub Date: 2025-07-05 DOI:10.1007/s00234-025-03703-0

Keisuke Yoshida, Kazuma Kowata, Takayuki Yatsu, Naoko Shibusawa, Natsumi Sato, Rikako Mogi, Kazunori Akaji

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引用次数: 0

Abstract

Purpose: The transradial approach is increasingly used in neurointervention due to its minimally invasive nature and lower risk of severe access-related complications. However, radial artery steno-occlusion, although generally asymptomatic, may limit future vascular access. This study aimed to evaluate the incidence, predictors, and recanalization of puncture artery steno-occlusion following trans-wrist neurointervention.

Methods: A retrospective institutional review was conducted on transradial and transulnar neurointerventions performed between February 2022 and May 2024. Postprocedural ultrasound was performed on the following day to assess puncture artery stenosis or occlusion. Risk factors were evaluated using univariate and multivariate logistic regression analyses. Follow-up ultrasound was conducted when available to assess recanalization.

Results: Among 96 therapeutic trans-wrist procedures, puncture artery steno-occlusion was observed in 21 cases (22%). Complete occlusion occurred in 16 cases (17%), all asymptomatic. Multivariate analysis identified local anesthesia (OR 8.0, p < 0.05) and absence of preprocedural antiplatelet medication (OR 4.3, p < 0.05) as significant risk factors. The steno-occlusion rate was lower (6.6%) in cases performed under general anesthesia with preprocedural antiplatelet therapy. Follow-up ultrasound (median: 3.5 months) was available in 11 cases (52%), revealing persistent stenosis in all 4 stenosis cases and spontaneous recanalization in 4 of 7 occlusion cases (57%).

Conclusion: Puncture artery steno-occlusion occurred in 22% of therapeutic trans-wrist neurointerventions. Local anesthesia and absence of preprocedural antiplatelet medication were significant risk factors. Follow-up revealed both persistent steno-occlusion and recanalization, underscoring the importance of vascular reassessment before repeated access.

查看原文本刊更多论文

经桡骨和经椎骨神经干预后穿刺动脉狭窄闭塞：发病率、预测因素和随访结果。

目的：经桡骨入路因其微创性和较低的严重通路相关并发症风险而越来越多地用于神经介入治疗。然而，桡动脉狭窄闭塞虽然通常无症状，但可能限制未来的血管通路。本研究旨在评估经腕神经介入治疗后穿刺动脉狭窄闭塞的发生率、预测因素和再通率。方法：对2022年2月至2024年5月间进行的经桡骨和经椎骨神经干预进行回顾性机构回顾。术后第二天行超声检查穿刺动脉狭窄或闭塞情况。使用单因素和多因素logistic回归分析评估危险因素。随访超声可评估再通。结果：96例经手腕手术中，有21例（22%）出现穿刺动脉狭窄闭塞。完全闭塞16例（17%），均无症状。多变量分析确定局部麻醉（OR 8.0, p）。结论：22%的治疗性经腕神经干预发生了穿刺动脉狭窄闭塞。局部麻醉和术前未使用抗血小板药物是重要的危险因素。随访显示持续狭窄闭塞和再通，强调血管重新评估在重复通路前的重要性。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.