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Published on: September 20, 2020
Prospective Follow-Up Assessment of Wrist Function After the Transradial Approach for Diagnostic Cerebral Catheter
Michael Braun1,2, Julian Kifmann1,3, Johannes Steinhart1
1Section of Neuroradiology, Bezirkskrankenhaus Guenzburg, 89312 Guenzburg, Germany.
Abstract:
Background: Structural and functional alterations resulting from radial access for cerebral diagnostic catheter angiography might contribute to impaired wrist function. This study aimed to evaluate the impact of the transradial approach for diagnostic cerebral procedures on wrist function, using prospective follow-up assessments. Methods: Wrist function was prospectively assessed by using the Patient-Rated Wrist Evaluation (PRWE) questionnaire at baseline (pre-procedural assessment), as well as at 1-month and 3-month follow-up assessments (PRWE: 0 to 100, with 0 indicating no functional impairment). Association analyses with demographic and clinical parameters were performed using univariate logistic regression models. Results: During the 12-month observation period, 35 patients were enrolled in the study. At baseline, 25 patients (71.4%) reported no wrist impairment, while 10 patients (28.6%) had PRWE scores of up to 51. At the 1-month assessment, seven participants (20%) experienced a worsening in wrist function, reflected by increased PRWE scores. Of these, five patients showed deterioration exceeding the minimum clinically important difference. Another eight participants (22.9%) showed an improvement. A worsening of wrist function between the baseline and 1-month follow-up was not significantly associated with age, sex, prior neurosurgical status, body mass index (BMI), total procedure duration, dose area product, or fluoroscopy time (p > 0.05). At the 3-month follow-up, none of the patients reported any wrist-related impairments. Conclusions: In this exploratory cohort, the use of the transradial approach for cerebral angiography resulted in no wrist-related impairment at the 3-month follow-up. Transient worsening occurred in 20%, including clinically relevant cases, underscoring the need for larger studies with objective outcome measures.
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