Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume

To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrate...

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Veröffentlicht in:The Journal of invasive cardiology 2012-11, Vol.24 (11), p.599-604
Hauptverfasser: Kasasbeh, Ehab S, Parvez, Babar, Huang, Robert L, Hasselblad, Michele Marie, Glazer, Mark D, Salloum, Joseph G, Cleator, John H, Zhao, David X
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container_end_page 604
container_issue 11
container_start_page 599
container_title The Journal of invasive cardiology
container_volume 24
creator Kasasbeh, Ehab S
Parvez, Babar
Huang, Robert L
Hasselblad, Michele Marie
Glazer, Mark D
Salloum, Joseph G
Cleator, John H
Zhao, David X
description To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrated a relationship between increased volume and decreased procedural time, no studies have looked at the integration of radial access over time. Data were collected from consecutive patients who presented to the Vanderbilt University Medical Center cardiac catheterization laboratory from January 1, 2009 to April 1, 2011. Patients who underwent radial access diagnostic catheterization with and without percutaneous coronary intervention were included in this study. A total of 1112 diagnostic cardiac catheterizations through the radial access site were analyzed. High-volume, intermediate-volume, and low-volume operators were grouped based on the percentage of procedures performed through a radial approach. From 2009 to 2011, there was a significant decrease in fluoroscopy time in all operator groups for diagnostic catheterization (P=.035). The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P
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The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P&lt;.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low-volume operators. However, lower-volume operators have a reduction in procedure-related parameters with increased radial cases. 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The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P&lt;.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low-volume operators. However, lower-volume operators have a reduction in procedure-related parameters with increased radial cases. 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subjects Aged
Cardiac Catheterization - methods
Fluoroscopy
Hospitals, High-Volume - statistics & numerical data
Hospitals, Low-Volume - statistics & numerical data
Humans
Learning Curve
Middle Aged
Radial Artery
Retrospective Studies
Specialization
Time Factors
title Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume
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