ORIGINAL ARTICLE

The safety of modified digital subtraction angiography in RSPAD Gatot Soebroto: a comprehensive outlook

Terawan Agus Putranto , Nyoto Widyo Astoro, Basuki Rachmad, Erwin Setiawan, Ardianto Pramono, Djuwita Djuwita, Taruna Ikrar

Terawan Agus Putranto
Department of Interventional Radiology, RSPAD Gatot Subroto The Indonesia Army Medical Sciences Institute, Jakarta, Indonesia.. Email: [email protected]

Nyoto Widyo Astoro
Department of Internal Medicine, RSPAD Gatot Subroto

Basuki Rachmad
Department of Anesthesiology & Reanimation RSPAD Gatot Soebroto

Erwin Setiawan
Department of Neurology, RSPAD Gatot Soebroto

Ardianto Pramono
Department of Interventional Radiology, RSPAD Gatot Subroto The Indonesia Army Medical Sciences Institute, Jakarta, Indonesia.

Djuwita Djuwita
RSPAD Gatot Soebroto

Taruna Ikrar
5The Indonesia Army Medical Sciences Institute, Jakarta, Indonesia. Pacific Health Sciences University, California, United States of America
Online First: February 01, 2020 | Cite this Article
Putranto, T., Astoro, N., Rachmad, B., Setiawan, E., Pramono, A., Djuwita, D., Ikrar, T. 2020. The safety of modified digital subtraction angiography in RSPAD Gatot Soebroto: a comprehensive outlook. Bali Medical Journal 9(1): 1-5. DOI:10.15562/bmj.v9i1.1604


INTRODUCTION. There are no recent estimates of the complication rate associated with Intra Arterial Heparin Flushing (IAHF). The purpose of this study was to estimate the rate of complication occurring during and after Intra Arterial Heparin Flushing.

METHOD. This report is a descriptive study based on analysis of interventional radiology database. The study involved patients who underwent IAHF procedure started from January 2018 until December 2018 in Rumah Sakit Pusat Angkatan Darat Gatot Soebroto (Indonesian Army Central Hospital). Subjects were assessed for their age, sex, medical history, diagnosis, intra-procedural complication, and post-procedural complication.

RESULT. All IAHF procedures were performed via transfemoral catheterisation and using a vascular closure device to help achieve homeostasis. Our population included 1223 (70,57%) male and 510 (29,43%) Female, with age ranging from 21 to 80 years old. The majority of the subject was in 51-60 years old age group (35,31%). All IAHF were technically successful. No intraprocedural complication was noted, there was no occurrence of iatrogenic vessel injury (dissection) and no neurological deficit secondary to IAHF procedures. There was some local complication after IAHF procedure such as hematoma 44 persons (2,54%), oedema around the puncture site six patients (0,35%), and bleeding at the puncture site three patients (0,17%). Beside local complication, there were several systemic complications such as allergy in 10 persons (0,58%). No neurological complication was reported after IAHF.

CONCLUSION. We concluded that IAHF has a relatively low rate of acute complication. Most complications were related to local hemostasis control, and no severe sequelae were found.

References

Huang T., Chang C., Liao C., Ho Y. Quantification of Blood Flow in Internal Cerebral Artery by Optical Flow Method on Digital Subtraction Angiography in Comparison with Time-Of-Flight Magnetic Resonance Angiography. PLoS One. 2013;8(1):e54678.

Scalzo F., Liebeskind D.S. Perfusion Angiography in Acute Ischemic Stroke. Comput Math Methods Med. 2016;2016(article ID 2478324):1–14.

Wiryadana K.A., Supadmanaba I.G.P., Samatra D.P.G.P. Progress and potential roles blood biomarkers of ischemic stroke in clinical setting. Indones J Biomed Sci. 2017;11(2):19–29.

Okamoto K., Sakai K., Yoshimura S. The Principle of Digital Subtraction Angiography and Radiological Protection. Interv Neuroradiol. 2000;6(suppl1):25–31.

Bashir Q., Ishfaq A., Baig A.A. Safety of Diagnostic Cerebral and Spinal Digital Subtraction Angiography in a Developing Country: A Single-Center Experience. Interv Neurol. 2018;7(1–2):99–109.

Vilela P. Advanced and future digital subtraction angiography (DSA) applications. In: Ramalho J, Castillo M, editors. Vascular Imaging of the Central Nervous System: Physical Principles, Clinical Applications and Emerging Techniques. New Jersey: John Wiley & Sons, Inc.; 2013. p. 229–53.

Resnick S.B., Resnick S.H., Weintraub J.L., Kothary N. Heparin in interventional radiology: A therapy in evolution. Semin Intervent Radiol. 2005;22(2):95–107.

Simpfendorfer C. Acute coronary occlusion after percutaneous transluminal coronary angioplasty. Cleve Clin J Med. 1988;55(5):429–32.

Bittl J.A., Ahmed W.H. Relation between abrupt vessel closure and the anticoagulant response to heparin or bivalirudin during coronary angioplasty. Am J Cardiol. 1998;82(8B):50P-56P.

Durran A.C., Watts C. Current trends in heparin use during arterial vascular interventional radiology. Cardiovasc Intervent Radiol. 2012;35(6):1308–14.

Putranto T.A., Yusuf I., Murtala B., Wijaya A. Intra Arterial Heparin Flushing Increases Cereberal Blood Flow in Chronic Ischemic Stroke Patients. Indones Biomed J. 2016;8(2):119.

Fujita M. Heparin and angiogenic therapy. Eur Heart J. 2000;21(4):270–4.

Walter J., Vogl M., Holderried M., Becker C., Brandes A., Sinner M.F., et al. Manual Compression versus Vascular Closing Device for Closing Access Puncture Site in Femoral Left-Heart Catheterization and Percutaneous Coronary Interventions: A Retrospective Cross-Sectional Comparison of Costs and Effects in Inpatient Care. Value Heal. 2017;20(6):769–76.

Dariushnia S.R., Zuckerman D.A., Stokes L.S., Kalva S.P., Saad W.E., Ganguli S., et al. Quality Improvement Guidelines for Vascular Access and Closure Device Use. J Vasc Interv Radiol. 2013;25(1):73–84.

Nelson E.E., Guyer A.E. The development of the ventral prefrontal cortex and social flexibility. Dev Cogn Neurosci. 2011;1(3):233–45.

Tavakol M., Ashraf S., Brener S.J. Risks and Complications of Coronary Angiography: A Comprehensive Review. Glob J Health Sci. 2011;4(1):65–93.

Cho J.-H., Lee H.-K. Evaluation of the Method of Hemostasis after Femoral Arterial Puncture. J Phys Ther Sci. 2014;26(7):955–9.

Cil B., Geyik S., Yavuz K., Saatci I., Koc O., Peynircioglu B., et al. The safety and efficacy of the Angio-Seal closure device in diagnostic and interventional neuroangiography setting: a single-center experience with 1,443 closures. Neuroradiology. 2007;49(9):739–46.

Gil-Gouveia R.S., Sousa R.F., Lopes L., Campos J., Martins I.P. Post-angiography headaches. J Headache Pain. 2008;9(5):327–30.

Kwon M.A., Hong C.K., Joo J.Y., Kim Y.B., Chung J. Headache After Cerebral Angiography: Frequency, Predisposing Factors, and Predictors of Recovery. J Neuroimaging. 2016;26(1):89–94.

Neergaard K., Galloe A.M., Dirksen K.L., Andersen I., Madsen E.B. Cardiac complications of intravenous digital subtraction angiography. Eur J Radiol. 1989;9(2):105–7.

Willinsky R.A., Taylor S.M., terBrugge K., Farb R.I., Tomlinson G., Montanera W., et al. Neurologic Complications of Cerebral Angiography: Prospective Analysis of 2,899 Procedures and Review of the Literature. Radiology. 2003;227(2):522–8.


No Supplementary Material available for this article.
Article Views      : 0
PDF Downloads : 0