{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:42:25Z","timestamp":1789875745782,"version":"4.0.1"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>BMI has been shown to affect choice of access site in coronary intervention procedures, with lower complications reported during transradial (TR) access. To the authors\u2019 knowledge, the effect of BMI on outcomes in patients undergoing diagnostic cerebral angiography remains undescribed. This study compares outcomes for BMI subgroups based on access site (TR vs transfemoral [TF] access).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors conducted a single-center retrospective study of patients who underwent diagnostic cerebral angiography between December 2019 and January 2024. Propensity score matching was used to create two similar cohorts (TR and TF). These cohorts were subdivided based on BMI: underweight (BMI &lt; 18.5), normal (BMI 18.5\u201325.0), overweight (BMI 25.1\u201329.9), and obese (BMI \u2265 30). Linear regression analysis and the chi-square test were used to compare outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Nine hundred thirty-six patients were stratified into two groups of 468 patients each. Procedure time was significantly shorter for TR access for all BMI subgroups, with a 13-minute reduction in procedure time among underweight patients. Patients with normal BMI, overweight patients, and obese patients experienced a reduction in procedure time of approximately 11, 10, and 13 minutes, respectively. Obese patients experienced significantly shorter length of stay (LOS; 1.33 days) with TR access. There were no significant differences between each BMI subgroup in access site complications, postoperative complications, and conversion of access from TR to TF.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>TR access in diagnostic cerebral angiography is associated with shorter procedure times and no increased risk of complications compared to TF access across all BMI subgroups. Obese patients experienced shorter LOS with TR access. This study adds to the literature on the safety and efficacy of TR access across all BMI subgroups. Further studies are necessary to validate these preliminary results.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.7.jns241183","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T01:33:09Z","timestamp":1731115989000},"page":"1-7","source":"Crossref","is-referenced-by-count":3,"title":["Procedural outcomes of the transradial versus transfemoral approach for diagnostic cerebral angiograms according to BMI: a propensity score\u2013matched analysis"],"prefix":"10.3171","author":[{"given":"Joanna M.","family":"Roy","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meah T.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kareem","family":"El Naamani","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazanin","family":"Saadat","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendell","family":"Gaskins","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maimuna","family":"Gigo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony A.","family":"Fuleihan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheritesh","family":"Amaravadi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arbaz","family":"Momin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basel","family":"Musmar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavropoula I.","family":"Tjoumakaris","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Reid","family":"Gooch","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Rosenwasser","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal M.","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Health Econ","first-page":"219","article-title":"The medical care costs of obesity: an instrumental variables approach","volume":"31","author":"Cawley J","year":"2012","unstructured":"Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012;31(1):219\u2013230."},{"issue":"1","key":"b2","series-title":"Stroke","first-page":"30","article-title":"Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox","volume":"42","author":"Vemmos K","year":"2011","unstructured":"Vemmos K, Ntaios G, Spengos K,  Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox. Stroke. 2011;42(1):30\u201336."},{"issue":"2","key":"b3","series-title":"Catheter Cardiovasc Interv","first-page":"211","article-title":"Radial PCI and the obesity paradox: insights from Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)","volume":"87","author":"McDonagh JR","year":"2016","unstructured":"McDonagh JR, Seth M, LaLonde TA,  Radial PCI and the obesity paradox: insights from Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2). Catheter Cardiovasc Interv. 2016;87(2):211\u2013219."},{"issue":"8","key":"b4","series-title":"JACC Cardiovasc Interv","first-page":"819","article-title":"Transradial versus transfemoral artery approach for coronary angiography and percutaneous coronary intervention in the extremely obese","volume":"5","author":"Hibbert B","year":"2012","unstructured":"Hibbert B, Simard T, Wilson KR,  Transradial versus transfemoral artery approach for coronary angiography and percutaneous coronary intervention in the extremely obese. JACC Cardiovasc Interv. 2012;5(8):819\u2013826."},{"issue":"4","key":"b5","series-title":"PLoS One","first-page":"e0124399","article-title":"Impact of body mass index on in-hospital complications in patients undergoing percutaneous coronary intervention in a Japanese real-world multicenter registry","volume":"10","author":"Numasawa Y","year":"2015","unstructured":"Numasawa Y, Kohsaka S, Miyata H,  Impact of body mass index on in-hospital complications in patients undergoing percutaneous coronary intervention in a Japanese real-world multicenter registry. PLoS One. 2015;10(4):e0124399."},{"issue":"2","key":"b6","series-title":"Pharm Stat","first-page":"150","article-title":"Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies","volume":"10","author":"Austin PC","year":"2011","unstructured":"Austin PC. Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm Stat. 2011;10(2):150\u2013161."},{"issue":"8","key":"b7","series-title":"J Stat Softw","first-page":"1","article-title":"MatchIt: nonparametric preprocessing for parametric causal inference","volume":"42","author":"Ho D","year":"2011","unstructured":"Ho D, Imai K, King G, Stuart EA. MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw. 2011;42(8):1\u201328."},{"issue":"1","key":"b8","series-title":"Biometrics","first-page":"475","article-title":"Sensitivity analyses informed by tests for bias in observational studies","volume":"79","author":"Rosenbaum PR","year":"2023","unstructured":"Rosenbaum PR. Sensitivity analyses informed by tests for bias in observational studies. Biometrics. 2023;79(1):475\u2013487."},{"issue":"9","key":"b9","series-title":"J Neurointerv Surg","first-page":"886","article-title":"Transradial approach for neurointerventions: a systematic review of the literature","volume":"12","author":"Joshi KC","year":"2020","unstructured":"Joshi KC, Beer-Furlan A, Crowley RW, Chen M, Munich SA. Transradial approach for neurointerventions: a systematic review of the literature. J Neurointerv Surg. 2020;12(9):886\u2013892."},{"issue":"3","key":"b10","series-title":"Interv Neuroradiol","first-page":"404","article-title":"Transradial access for cerebral angiography and neurointerventional procedures: a meta-analysis and systematic review","volume":"30","author":"Rentiya ZS","year":"2024","unstructured":"Rentiya ZS, Kuhn AL, Hutnik R,  Transradial access for cerebral angiography and neurointerventional procedures: a meta-analysis and systematic review. Interv Neuroradiol. 2024;30(3):404\u2013411."},{"issue":"8","key":"b11","series-title":"J Neurointerv Surg","first-page":"752","article-title":"Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures","volume":"13","author":"Catapano JS","year":"2021","unstructured":"Catapano JS, Ducruet AF, Koester SW,  Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures. J Neurointerv Surg. 2021;13(8):752\u2013754."},{"issue":"2","key":"b12","series-title":"Neurosurg Clin N Am","first-page":"161","article-title":"Radial access intervention","volume":"33","author":"Restrepo-Orozco A","year":"2022","unstructured":"Restrepo-Orozco A, Abouelleil M, Verhey L,  Radial access intervention. Neurosurg Clin N Am. 2022;33(2):161\u2013167."},{"key":"b13","series-title":"Interv Neuroradiol","article-title":"Analysis of treatment cost differences in patients undergoing femoral versus radial access in outpatient diagnostic cerebral arteriograms","author":"Findlay MC","unstructured":"Findlay MC, Baker CM, Childs S,  Analysis of treatment cost differences in patients undergoing femoral versus radial access in outpatient diagnostic cerebral arteriograms. Interv Neuroradiol. Published online October 10, 2023. doi:10.1177\/15910199231207408"},{"issue":"5","key":"b14","series-title":"J Neurosurg","first-page":"1328","article-title":"Transradial versus transfemoral access routes for diagnostic cerebral angiography: a large single-center comparative cost-analysis study","volume":"140","author":"Atallah E","year":"2023","unstructured":"Atallah E, El Naamani K, Momin AA,  Transradial versus transfemoral access routes for diagnostic cerebral angiography: a large single-center comparative cost-analysis study. J Neurosurg. 2023;140(5):1328\u20131334."},{"issue":"9","key":"b15","series-title":"J Neurointerv Surg","first-page":"874","article-title":"Transradial cerebral angiography: techniques and outcomes","volume":"10","author":"Snelling BM","year":"2018","unstructured":"Snelling BM, Sur S, Shah SS,  Transradial cerebral angiography: techniques and outcomes. J Neurointerv Surg. 2018;10(9):874\u2013881."},{"issue":"6","key":"b16","series-title":"BMJ Case Rep","first-page":"e234078","article-title":"Transradial intracranial aneurysm treatment via an aberrant right subclavian artery","volume":"13","author":"Jha N","year":"2020","unstructured":"Jha N, Selkirk G, Crockett MT, Phillips TJ. Transradial intracranial aneurysm treatment via an aberrant right subclavian artery. BMJ Case Rep. 2020;13(6):e234078."},{"issue":"2","key":"b17","series-title":"J Interv Cardiol","first-page":"236","article-title":"Clinical factors associated with physician choice of femoral versus radial access: a real-world experience from a single academic center","volume":"31","author":"Yee J","year":"2018","unstructured":"Yee J, Kumar V, Li S,  Clinical factors associated with physician choice of femoral versus radial access: a real-world experience from a single academic center. J Interv Cardiol. 2018;31(2):236\u2013243."},{"key":"b18","series-title":"World Neurosurg","first-page":"e32","article-title":"Comparison of radial versus femoral access for neuroendovascular procedures in very high body mass index individuals","volume":"184","author":"Kolb B","year":"2024","unstructured":"Kolb B, Joshi K, Sim J,  Comparison of radial versus femoral access for neuroendovascular procedures in very high body mass index individuals. World Neurosurg. 2024;184:e32\u2013e38."},{"key":"b19","series-title":"Int J Cardiol","first-page":"169","article-title":"Radial artery diameter does not correlate with body mass index: a duplex ultrasound analysis of 1706 patients undergoing trans-radial catheterization at three experienced radial centers","volume":"228","author":"Dharma S","year":"2017","unstructured":"Dharma S, Kedev S, Patel T, Rao SV, Bertrand OF, Gilchrist IC. Radial artery diameter does not correlate with body mass index: a duplex ultrasound analysis of 1706 patients undergoing trans-radial catheterization at three experienced radial centers. Int J Cardiol. 2017;228:169\u2013172."},{"issue":"10","key":"b20","series-title":"J Neurointerv Surg","first-page":"993","article-title":"Transradial versus transfemoral approaches for diagnostic cerebral angiography: a prospective, single-center, non-inferiority comparative effectiveness study","volume":"12","author":"Stone JG","year":"2020","unstructured":"Stone JG, Zussman BM, Tonetti DA,  Transradial versus transfemoral approaches for diagnostic cerebral angiography: a prospective, single-center, non-inferiority comparative effectiveness study. J Neurointerv Surg. 2020;12(10):993\u2013998."},{"issue":"5","key":"b21","series-title":"Eur J Cardiovasc Nurs","first-page":"454","article-title":"Bed rest duration and complications after transfemoral cardiac catheterization: a network meta-analysis","volume":"22","author":"Busca E","year":"2023","unstructured":"Busca E, Airoldi C, Bertoncini F,  Bed rest duration and complications after transfemoral cardiac catheterization: a network meta-analysis. Eur J Cardiovasc Nurs. 2023;22(5):454\u2013462."},{"issue":"4","key":"b22","series-title":"Int J Evid-Based Healthc","first-page":"352","article-title":"The clinical effectiveness of length of bed rest for patients recovering from trans-femoral diagnostic cardiac catheterisation","volume":"6","author":"Chair SY","year":"2008","unstructured":"Chair SY, Fernandez R, Lui MHL, Lopez V, Thompson DR. The clinical effectiveness of length of bed rest for patients recovering from trans-femoral diagnostic cardiac catheterisation. Int J Evid-Based Healthc. 2008;6(4):352\u2013390."},{"issue":"1","key":"b23","series-title":"J Neuroimaging","first-page":"67","article-title":"Improved fluoroscopy and time efficiency with radial access for diagnostic cerebral angiography","volume":"31","author":"Kenawy AE","year":"2021","unstructured":"Kenawy AE, Tekle W, Hassan AE. Improved fluoroscopy and time efficiency with radial access for diagnostic cerebral angiography. J Neuroimaging. 2021;31(1):67\u201370."},{"issue":"8","key":"b24","series-title":"Cardiovasc Revasc Med","first-page":"491","article-title":"The fluoroscopy time, door to balloon time, contrast volume use and prevalence of vascular access site failure with transradial versus transfemoral approach in ST segment elevation myocardial infarction: a systematic review & meta-analysis","volume":"16","author":"Singh S","year":"2015","unstructured":"Singh S, Singh M, Grewal N, Khosla S. The fluoroscopy time, door to balloon time, contrast volume use and prevalence of vascular access site failure with transradial versus transfemoral approach in ST segment elevation myocardial infarction: a systematic review & meta-analysis. Cardiovasc Revasc Med. 2015;16(8):491\u2013497."},{"issue":"2","key":"b25","series-title":"EuroIntervention","first-page":"183","article-title":"Randomised comparison of manual compression and FemoSeal\u2122 vascular closure device for closure after femoral artery access coronary angiography: the CLOSure dEvices Used in everyday Practice (CLOSE-UP) study","volume":"10","author":"Holm NR","year":"2014","unstructured":"Holm NR, Sindberg B, Schou M,  Randomised comparison of manual compression and FemoSeal\u2122 vascular closure device for closure after femoral artery access coronary angiography: the CLOSure dEvices Used in everyday Practice (CLOSE-UP) study. EuroIntervention. 2014;10(2):183\u2013190."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/aop\/article-10.3171-2024.7.JNS241183\/article-10.3171-2024.7.JNS241183.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/aop\/article-10.3171-2024.7.JNS241183\/article-10.3171-2024.7.JNS241183.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/aop\/article-10.3171-2024.7.JNS241183\/article-10.3171-2024.7.JNS241183.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T08:40:13Z","timestamp":1743237613000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/aop\/article-10.3171-2024.7.JNS241183\/article-10.3171-2024.7.JNS241183.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":25,"URL":"https:\/\/doi.org\/10.3171\/2024.7.jns241183","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}