Comparison of Percutaneous Coronary Intervention Safety Before and During the Establishment of a Transradial Program at a Teaching Hospital

Overview

Journal Am J Cardiol

Specialty Cardiology & Vascular Diseases

Date 2012 Jan 17

PMID 22245405

Citations 2

Authors

Robert A Leonardi

Jacob C Townsend

D Dirk Bonnema

Chetan A Patel

Michael T Gibbons

Thomas M Todoran

Christopher D Nielsen

Eric R Powers

Daniel H Steinberg

Affiliations

Soon will be listed here.

Abstract

This study sought to examine the safety of percutaneous coronary intervention (PCI) before and during de novo establishment of a transradial (TR) program at a teaching hospital. TR access remains underused in the United States, where cardiology fellowship programs continue to produce cardiologists with little TR experience. Establishment of TR programs at teaching hospitals may affect PCI safety. Starting in July 2009 a TR program was established at a teaching hospital. PCI-related data for academic years 2008 to 2009 (Y1) and 2009 to 2010 (Y2) were prospectively collected and retrospectively analyzed. Of 1,366 PCIs performed over 2 years, 0.1% in Y1 and 28.7% in Y2 were performed by TR access. No major complications were identified in 194 consecutive patients undergoing TR PCI, and combined bleeding and vascular complication rates were lower in Y2 versus Y1 (0.7% vs 2.0%, p = 0.05). Patients treated in Y2 versus Y1 and by TR versus transfemoral approach required slightly more fluoroscopy but similar contrast volumes and had similar procedural durations, lengths of stay, and predischarge mortality rates. PCI success rates were 97% in Y1, 97% in Y2, and 98% in TR cases. TR PCIs were performed by 13 cardiology fellows and 9 attending physicians, none of whom routinely performed TR PCI previously. In conclusion, de novo establishment of a TR program improved PCI safety at a teaching hospital. TR programs are likely to improve PCI safety at other teaching hospitals and should be established in all cardiology fellowship training programs.

Citing Articles

Transradial versus transfemoral rotablation for heavily calcified coronary lesions in contemporary drug-eluting stent era.

Yin W, Tseng C, Tsao T, Jen H, Huang W, Huang C J Geriatr Cardiol. 2015; 12(5):489-96.

PMID: 26512239 PMC: 4605943. DOI: 10.11909/j.issn.1671-5411.2015.05.004.

Transradial versus transfemoral approach in patients undergoing percutaneous coronary intervention for acute coronary syndrome. A meta-analysis and trial sequential analysis of randomized controlled trials.

Piccolo R, Galasso G, Capuano E, De Luca S, Esposito G, Trimarco B PLoS One. 2014; 9(5):e96127.

PMID: 24820096 PMC: 4018335. DOI: 10.1371/journal.pone.0096127.

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