American journal of translational research · 2025
A predictive model discloses independent risk factors for vascular complications in elderly cerebrovascular accident patients after trans-radial access cerebral angiography.
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Wang Yao, Yang Lingli, Li Xin, Gu Bei
Аннотация
OBJECTIVE: To identify the risk factors for vascular complications after total cerebral angiography by trans-radial access (TRA) in elderly cerebrovascular accident (CVA) patients and develop a predictive model.
METHODS: Data from 248 elderly CVA patients at Lianyungang Affiliated Hospital from December 2021 to March 2024 were retrospectively analyzed. The patients were divided into two groups: complicated (those with vascular complications) and non-complicated (those without vascular complications). Clinical data were collected and analyzed. Risk factors were identified using multifactorial logistic regression.
RESULTS: A total of 62 patients experienced vascular complications. Independent risk factors included intraoperative heparin dosage, number of radial artery punctures, timing of surgery, surgical time, mode of pressure hemostasis, duration of pressure hemostasis, and postoperative HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) score (P<0.05). The nomogram model for predicting complications showed a good Hosmer-Lemeshow fit (χ2=2.099, P=0.978). Receiver operating characteristic analysis revealed an area under the curve of 0.868 [95% confidence interval (CI) (0.800, 0.936)] for the training set and 0.822 [95% CI (0.723, 0.921)] for the validation set. Decision curve analysis showed a net benefit >0 in both sets within certain risk thresholds.
CONCLUSIONS: Vascular complications following total cerebral angiography by TRA in elderly CVA patients are associated with multiple factors. The nomogram model developed from these risk factors has significant predictive value.
METHODS: Data from 248 elderly CVA patients at Lianyungang Affiliated Hospital from December 2021 to March 2024 were retrospectively analyzed. The patients were divided into two groups: complicated (those with vascular complications) and non-complicated (those without vascular complications). Clinical data were collected and analyzed. Risk factors were identified using multifactorial logistic regression.
RESULTS: A total of 62 patients experienced vascular complications. Independent risk factors included intraoperative heparin dosage, number of radial artery punctures, timing of surgery, surgical time, mode of pressure hemostasis, duration of pressure hemostasis, and postoperative HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) score (P<0.05). The nomogram model for predicting complications showed a good Hosmer-Lemeshow fit (χ2=2.099, P=0.978). Receiver operating characteristic analysis revealed an area under the curve of 0.868 [95% confidence interval (CI) (0.800, 0.936)] for the training set and 0.822 [95% CI (0.723, 0.921)] for the validation set. Decision curve analysis showed a net benefit >0 in both sets within certain risk thresholds.
CONCLUSIONS: Vascular complications following total cerebral angiography by TRA in elderly CVA patients are associated with multiple factors. The nomogram model developed from these risk factors has significant predictive value.