Dijital substraksiyon anjiografide komplikasyonlar: ilk üç yıllık deneyim

Year 2024, , 227 - 235, 01.04.2024

Serkan Civlan , Berk Burak Berker , Fatih Yakar , Eylem Teke , Erdal Çoşkun

https://doi.org/10.31362/patd.1404483

Abstract

Amaç: Bu çalışmada ilk üç yıllık deneyimimiz boyunca dijital substraksiyon anjiyografilerde (DSA) karşılaştığımız komplikasyonlar anlatılmış olup, hasta popülasyonumuzdaki risk faktörleri değerlendirilmiştir.
Gereç ve yöntem: Kurumumuzda Nisan 2019'dan Mayıs 2022'ye kadar farklı patolojilere sahip 507 hastaya DSA işlemi uygulandı ve sonuçlar retrospektif olarak değerlendirildi. Anjiyografi sırasında herhangi bir nörolojik sekel saptanmasa bile işlem tarihi, hastanın yaşı, cinsiyeti, yandaş hastalıkları, kateter tipleri, kullanılan kateter sayısı ve işleme bağlı tüm komplikasyonlar kaydedildi. Komplikasyonlar nörolojik, nörolojik olmayan veya lokal olarak kategorize edildi.
Bulgular: Çalışmamıza toplam 507 hasta dahil edildi. Hastaların 256'sı (%50,5) erkek, 251'i (%49,5) kadın olmakla beraber, ortalama yaşı 49,2 (5-91 arası) olarak saptandı. Primer patolojilere en çok eşlik eden hastalığın hipertansiyon olduğu görüldü (%22,5). 507 hastadan toplam 10 hastada nörolojik komplikasyon, radyolojik komplikasyon veya anjiyo bölgesine bağlı komplikasyon görüldü ve genel komplikasyon oranı %0,02 olarak bulundu. Nörolojik komplikasyon gelişen 6 hastanın 3'ünde (%0,6) kalıcı nörolojik defisit, 3'ünde (%0,6) ise geçici nörolojik defisit saptandı. Nörolojik olmayan komplikasyon gelişen 4 hastada iki olguda asemptomatik vazospazm, bir olguda internal karotid arter (İKA) diseksiyonu, bir olguda skrotal hematom gözlendi.
Sonuç: Dijital substraksiyon anjiografi esnasında komplikasyonlarla nadir olarak karşılaşılsa bile hastaların özelliklerinin bilinmesi ve uygun endikasyonun belirlenmesi ile komplikasyon oranı en az seviyeye indirilebilir. Risk oranının düşük olmasına ragmen tromboembolizm gibi komplikasyonlar kalıcı nörolojik defisitlere ve hatta ölüme neden olabilir.

Keywords

Dijital substraksiyon anjiografi, nörolojik komplikasyon, nörolojik olmayan komplikasyon, kateter, vazospazm

Complications in digital subtraction angiography: initial three years of experience

Abstract

Purpose: In this study, we describe the complications we encountered during digital subtraction angiographies (DSA) in our initial three years of experience and evaluate the risk factors in our patient population.
Materials and methods: A series of 507 patients with different pathological processes were diagnosed via DSA in our institution from April 2019 through May 2022 and were retrospectively evaluated. During DSA, the date of the procedure, patient age, gender, comorbidities, catheter types, number of catheters used, and all procedure-related complications were recorded, even if they did not cause any neurological sequelae. Complications were categorized as neurological, non-neurological, or local.
Results: Our study included a total of 507 patients. Of these, 256 (50.5%) were male, and 251 (49.5%) were female. The mean age of patients was 49.2 years (range 5-91). The most preexisting comorbidity in patients was hypertension (22.5%). Of 507 patients, a total of 10 patients had either a neurological complication, radiological complication, or angio-site-related complication, and the overall rate of complications was 0.02%. In 6 patients with neurological complications, 3 (0.6%) had permanent neurological deficits, and 3 (0.6%) had transient deficits. In 4 patients with non-neurological complications, asymptomatic vasospasms were encountered in two cases; internal carotid artery (ICA) dissection was experienced in one case, and scrotal hematoma was observed in one case.
Conclusion: Complications following DSA are rare but must be minimized with knowledge of the characteristics of the patients and determining the proper indication. Although the risk is low, complications such as thromboembolism can cause permanent neurological deficits and even death.

Keywords

Digital subtraction angiography, neurological complication, non-neurological complication, catheter, vasospasm

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