Published: 2022-01-29

Incidence and predictors of groin complication after cerebral neurointervention procedure: single centre study

Fritz Sumantri Usman, Merlin Prisilia Kastilong, Beny Kurniawan, Mohammad Soleh, Erman Keneddy, Haekal Alaztha, Lenny Octavinawaty


Background: Cerebrovascular disease is characterized by an acute compromise of the cerebral perfusion or vascular which caused morbidity and mortality around the world. The most accurate imaging technique for the evaluation of cerebrovascular system is digital subtraction angiography (DSA), but it can cause many complications, one of the most is groin complication. Our objective was to determine incidence and predictors of groin complication after cerebral neurointervention procedure.

Methods: An observational prospective study was conducted in PELNI hospital, from January until June 2021, with a total sample of 246 patients. We observed hematoma that occurred within 24 h after procedure. Data was analysed using SPSS ver 24. 

Results: There were 246 patients who underwent DSA procedures. The average age of patients was 54.3±11.9 years and the majority were male (59.5%). The incidence of groin complication was 37.4%. The predictors of groin complication evaluated with bivariate analysis were age (p=0.167), gender (p=0.827), frequency of puncture (p=0.178), catheter size (p=0.200), duration of compression (p=0.477), comorbidities (hypertension; p=0.839, diabetes; p=0.178, heart disease; p=0.373), and history of anticoagulant (p=0.022). Multivariate analysis showed that history of anticoagulant (p=0.023, OR=2.118 (95% CI 1.107-4.049) to be the most significant factors contributing to groin complication after the intervention.

Conclusions: Groin complications appeared to be the most complications after cerebral neurointervention procedure with incidence rate 37.4% and associated mostly with the history of anticoagulant.


Neurointervention procedure, Groin complications, Hematoma

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Khaku S, Tadi P. Cerebrovascular Disease. In: StatPearls, 2021. Available at Accessed 1 November 2021.

Kemenkes RI. Riset Kesehatan Dasar 2013. Jakarta: Balitbangkes. 2013;126-9.

Kemenkes RI. Riset Kesehatan Dasar 2018. Jakarta: Balitbangkes. 2018;164-9.

Fadhilah H, Permanasari VY. Economic Burden Bore by Patients and Families because of stroke: Policy Assessment. J Indonesian Health Policy Administration. 2020;5(3):91-5.

Burger IM, Murphy KJ, Jordan LC, Tamargo RJ, Gailloud P. Safety of Cerebral Digital Subtraction Angiography in Children: Complication Rate Analysis in 241 Consecutive Diagnostic Angiograms. Stroke 2006;37:2535-9.

Harrigan M, Deveikis JP. Handbook of Cerebrovascular Disease and Neurointerventional Technique. 3rd ed. USA. Humana Press. 2009.

Al-Momani M, AbuRuz ME. Incidence and predictor of groin complications early after coronary artery intervention: a prospective observational study. BMC Nursing. 2019;18:24.

Tini K, Samatra IDPGP, Wiryadana KA, Supadmanaba IGP. Clinical profile of patients with cerebrovascular disease at Stroke Unit, Sanglah General Hospital, Denpasar, Bali. Bali Med J. 2020;9(1):129-36.

Setyopranoto I, Bayuangga HF, Panggabean AS, Sarastiti. Prevalence of Stroke an Associated Risk Factors in Sleman District of Yogyakarta Special Region, Indonesia. Stroke Res Treat. 2019;5:1-8.

Izzo C, Carrizzo A, Alfano A, Virtuoso N, Capunzo M, Calabrese M et al. The Impact of Aging on Cardio and Cerebrovascular Diseases. Int J Mol Sci. 2018;19:481.

Samuels C. 2020. Skin bruising in elderly: causes and prevention. 2020. Available at: http: Accessed 20 October 2021.

Collo SB, Bennet DA, Krishnamurti R. Sex Differences in Stroke Incidence, Prevalence, Mortality and DALYs: Results from the Global Burden of Disease Study 2013. Neuroepidemiology. 2015;45(3):203-14.

Bushnell CD, Chaturvedi S, Gage KR, Herson PS, Hurn PD, Jiménez MC et al. Sex differences in stroke: Challenges and opportunities. J Cereb Blood Flow Metab. 2018;38(12):2179-91.

Rahrovan S, Fanian F, Mehryan P, Humbert P, Firooz A. Male versus female skin: What dermatologists and cosmeticians should know. Int J Womens Dermatol. 2018;4(3):122-30.

Oneissi M, Sweid A, Tjoumakaris S, Hasan D, Gooch MR, Rosenwasser RH et al. Access-Site Complications in Transfemoral Neuroendovascular Procedures: A Systematic Review of Incidence Rates and Management Strategies. Oper Neurosurg. 2020;19(4):353-63.

Kurisu K, Osanai T, Kazumata K, Nakayama N, Abumiya T, Shichinohe H et al. Ultrasound-guided Femoral Artery Access for Minimally Invasive Neuro-intervention and Risk Factors for Access Site Hematoma. Neurol Med Chir (Tokyo). 2016;56(12):745-52.

Bangalore S, Bhatt DL. Diagnostic and Therapeutic Cardiovascular Procedures: Femoral Arterial Access and Closure. AHA J. 2011;124(5):147-56.

Doyle BJ, Konz BA, Lennon RJ, Bresnahan JF, Rihal CS, Ting HH. Ambulation 1 Hour After Diagnostic Cardiac Catheterization: A Prospective Study of 1009 Procedures. Mayo Clin Proc. 2006;81(12):1537-40.

Koreny M, Riedmuller E, Nikfardjam P. Arterial puncture closing devices compared with standard manual compression after cardiac catheterization. JAMA. 2004;291:350-7.

Dumont CJ. Blood pressure and risks of vascular complications after percutaneous coronary intervention. Dimens Crit Care Nurs. 2007;26(3):121-7.

Windy C. The impact of oral anticoagulants on wound healing and development in an aging population, 2021. Available at: Accessed 1 November 2021.