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 (χ 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.