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Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma

Although ultrasound (US) guidance for venous access is becoming the “standard of care” for preventing access site complications, its feasibility for arterial access has not been fully investigated, especially in the neuro-interventional population. We conducted the first prospective cohort study on...

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Autores principales: KURISU, Kota, OSANAI, Toshiya, KAZUMATA, Ken, NAKAYAMA, Naoki, ABUMIYA, Takeo, SHICHINOHE, Hideo, SHIMODA, Yusuke, HOUKIN, Kiyohiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221772/
https://www.ncbi.nlm.nih.gov/pubmed/27194178
http://dx.doi.org/10.2176/nmc.oa.2016-0026
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author KURISU, Kota
OSANAI, Toshiya
KAZUMATA, Ken
NAKAYAMA, Naoki
ABUMIYA, Takeo
SHICHINOHE, Hideo
SHIMODA, Yusuke
HOUKIN, Kiyohiro
author_facet KURISU, Kota
OSANAI, Toshiya
KAZUMATA, Ken
NAKAYAMA, Naoki
ABUMIYA, Takeo
SHICHINOHE, Hideo
SHIMODA, Yusuke
HOUKIN, Kiyohiro
author_sort KURISU, Kota
collection PubMed
description Although ultrasound (US) guidance for venous access is becoming the “standard of care” for preventing access site complications, its feasibility for arterial access has not been fully investigated, especially in the neuro-interventional population. We conducted the first prospective cohort study on US-guided femoral artery access during neuro-interventional procedure. This study included 64 consecutive patients who underwent US-guided femoral artery access through 66 arterial access sites for diagnostic and/or neuro-interventional purposes. The number of attempts required for both the sheath insertion and the success of anterior wall puncture were recorded. In addition, the occurrence of major complications and hematoma formation on the arterial access site examined by US were statistically analyzed. The median number of attempts was 1 (1–2) and first-pass success rate was 63.6%. Anterior wall puncture was achieved in 98.5%. In one case (1.5%), a pseudoaneurysm was observed. In all cases, US clearly depicted a common femoral artery (CFA) and its bifurcation. Post-procedural hematoma was detected in 13 cases (19.7%), most of which were “tiny” or “moderate” in size. Low body mass index and antiplatelet therapy were the independent risk factors for access site hematoma. The US-guided CFA access was feasible even in neuro-interventional procedure. The method was particularly helpful in the patients with un-palpable pulsation of femoral arteries. To prevent arterial access site hematoma, special care should be taken in patients with low body mass index and who are on antiplatelet therapy.
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spelling pubmed-52217722017-01-17 Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma KURISU, Kota OSANAI, Toshiya KAZUMATA, Ken NAKAYAMA, Naoki ABUMIYA, Takeo SHICHINOHE, Hideo SHIMODA, Yusuke HOUKIN, Kiyohiro Neurol Med Chir (Tokyo) Original Article Although ultrasound (US) guidance for venous access is becoming the “standard of care” for preventing access site complications, its feasibility for arterial access has not been fully investigated, especially in the neuro-interventional population. We conducted the first prospective cohort study on US-guided femoral artery access during neuro-interventional procedure. This study included 64 consecutive patients who underwent US-guided femoral artery access through 66 arterial access sites for diagnostic and/or neuro-interventional purposes. The number of attempts required for both the sheath insertion and the success of anterior wall puncture were recorded. In addition, the occurrence of major complications and hematoma formation on the arterial access site examined by US were statistically analyzed. The median number of attempts was 1 (1–2) and first-pass success rate was 63.6%. Anterior wall puncture was achieved in 98.5%. In one case (1.5%), a pseudoaneurysm was observed. In all cases, US clearly depicted a common femoral artery (CFA) and its bifurcation. Post-procedural hematoma was detected in 13 cases (19.7%), most of which were “tiny” or “moderate” in size. Low body mass index and antiplatelet therapy were the independent risk factors for access site hematoma. The US-guided CFA access was feasible even in neuro-interventional procedure. The method was particularly helpful in the patients with un-palpable pulsation of femoral arteries. To prevent arterial access site hematoma, special care should be taken in patients with low body mass index and who are on antiplatelet therapy. The Japan Neurosurgical Society 2016-12 2016-05-17 /pmc/articles/PMC5221772/ /pubmed/27194178 http://dx.doi.org/10.2176/nmc.oa.2016-0026 Text en © 2016 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
KURISU, Kota
OSANAI, Toshiya
KAZUMATA, Ken
NAKAYAMA, Naoki
ABUMIYA, Takeo
SHICHINOHE, Hideo
SHIMODA, Yusuke
HOUKIN, Kiyohiro
Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma
title Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma
title_full Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma
title_fullStr Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma
title_full_unstemmed Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma
title_short Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma
title_sort ultrasound-guided femoral artery access for minimally invasive neuro-intervention and risk factors for access site hematoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221772/
https://www.ncbi.nlm.nih.gov/pubmed/27194178
http://dx.doi.org/10.2176/nmc.oa.2016-0026
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