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Ultrasonography is an imaging technique that uses high-frequency sound waves to visualize the body's internal structures. It is a non-invasive and safe procedure that does not involve the use of ionizing radiation, making it widely used in various medical fields. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development.
During an ultrasonography procedure, a handheld device called...
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Does ultrasound guidance decrease femoral access site complications in neurointerventional procedures? A

Tze Phei Kee1, Emily M Chung2, Saba Ghazimoghadam2

  • 1The Division of Neuroradiology, Joint Department of Medical Imaging and University Medical Imaging Toronto, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada; Department of Neuroradiology, National Neuroscience Institute, Singapore.

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Ultrasound guidance for femoral arterial access in neuroendovascular procedures did not significantly reduce access site complications. However, it proved beneficial for high-risk cases, with larger sheath size and interventional procedures being key predictors of complications.

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Area of Science:

  • Neuroendovascular procedures
  • Vascular access
  • Medical imaging

Background:

  • Ultrasound is increasingly used for femoral arterial access in neuroendovascular procedures.
  • The impact of ultrasound guidance on safety outcomes for this access method is not well-established.

Purpose of the Study:

  • To evaluate the effect of ultrasound-guided femoral arterial punctures on access site complications (ASC).
  • To identify independent predictors of ASC in neuroendovascular procedures.

Main Methods:

  • Retrospective analysis of neurovascular cases using femoral arterial access (Jan 2016 - Dec 2022).
  • Comparison of two groups: pre-ultrasound guidance (Jan 2017 - Dec 2017) and ultrasound-guided (July 2019 - Dec 2022).
  • Univariable and multivariable logistic regression analyses were performed.

Main Results:

  • A total of 3181 procedures were analyzed (1376 non-ultrasound, 1805 ultrasound).
  • Overall femoral arterial access complication rate was 2%.
  • No statistically significant difference in complication rates between ultrasound and non-ultrasound groups (p=0.821).
  • Independent predictors of ASC included interventional procedures (e.g., endovascular therapy - EVT), larger sheath size (>=7Fr), and dual antiplatelet therapy (DAPT).

Conclusions:

  • Ultrasound guidance does not significantly impact the safety of femoral arterial access in neuroendovascular procedures.
  • Ultrasound is beneficial in high-risk cases, potentially minimizing complications.
  • Interventional procedures, larger sheath size, and DAPT are independent predictors of femoral ASC.