Predictors of Transfemoral Access Site Complications in Neuroendovascular Procedures: A large Single-Center Cohort Study.
Publication/Presentation Date
10-1-2023
Abstract
OBJECTIVE: The transfemoral (TF) route has historically been the preferred access site for endovascular procedures. However, despite its widespread use, TF procedures may confer morbidity as a result of access site complications. The aim of this study is to provide the rate and predictors of TF access site complications for neuroendovascular procedures.
METHODS: This is a single center retrospective study of TF neuroendovascular procedures performed between 2017 and 2022. The incidence of complications and associated risk factors were analyzed across a large cohort of patients.
RESULTS: The study comprised of 2043 patients undergoing transfemoral neuroendovascular procedures. The composite rate of access site complications was 8.6 % (n = 176). These complications were divided into groin hematoma formation (n = 118, 5.78 %), retroperitoneal hematoma (n = 14, 0.69 %), pseudoaneurysm formation (n = 40, 1.96 %), and femoral artery occlusion (n = 4, 0.19 %). The cross-over to trans radial access rate was 1.1 % (n = 22). On univariate analysis, increasing age (OR=1.0, p = 0.06) coronary artery disease (OR=1.7, p = 0.05) peripheral vascular disease (OR=1.9, p = 0.07), emergent mechanical thrombectomy procedures (OR=2.1, p < 0.001) and increasing sheath size (OR=1.3, p < 0.001) were associated with higher TF access site complications. On multivariate analysis, larger sheath size was an independent risk factor for TF access site complications (OR=1.8, p = 0.02).
CONCLUSION: Several pertinent factors contribute towards the incidence of TF access site complications. Factors associated with TF access site complications include patient demographics (older age) and clinical risk factors (vascular disease), as well as periprocedural factors (sheath size).
Volume
233
First Page
107916
Last Page
107916
ISSN
1872-6968
Published In/Presented At
El Naamani, K., Khanna, O., Mastorakos, P., Momin, A. A., Yudkoff, C. J., Jain, P., Hunt, A., Pedapati, V., Syal, A., Lawall, C. L., Carey, P. M., El Fadel, O., Zakar, R. M., Ghanem, M., Muharremi, E., Jreij, G., Abbas, R., Amllay, A., Gooch, M. R., Herial, N. A., … Tjoumakaris, S. I. (2023). Predictors of Transfemoral Access Site Complications in Neuroendovascular Procedures: A large Single-Center Cohort Study. Clinical neurology and neurosurgery, 233, 107916. https://doi.org/10.1016/j.clineuro.2023.107916
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
37651797
Department(s)
Administration and Leadership
Document Type
Article