Perceptions of advantages and barriers to radial-access percutaneous coronary intervention in VA cardiac catheterization laboratories
| Autor: | Chris L. Bryson, Christian D. Helfrich, Thomas T. Tsai, Adhir R. Shroff, Jaclyn M. Lemon, Sunil V. Rao, Evercita C. Eugenio, Mladen I. Vidovich, Bernadette Speiser |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Hemorrhage Lower risk Percutaneous Coronary Intervention Surveys and Questionnaires medicine Humans Health services research Survey research Cardiac catheterization Patient comfort Response rate (survey) business.industry Percutaneous coronary intervention General Medicine medicine.disease Femoral Artery Treatment Outcome Radial artery Conventional PCI Emergency medicine Access site Dissemination & implementation Medical emergency Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular Revascularization Medicine. 15:329-333 |
| ISSN: | 1553-8389 |
| DOI: | 10.1016/j.carrev.2014.08.006 |
| Popis: | Background/Purpose Compared with trans-femoral percutaneous coronary intervention (TFI), trans-radial PCI (TRI) has a lower risk of bleeding, access site complications and hospital costs, and is preferred by patients. However, TRI accounts for a minority of PCIs in the US, and there is currently little research that explores why. Methods/Material We conducted a national survey in February 2013 to assess perceptions of TRI vs. TFI, and barriers to TRI adoption and implementation among interventional cardiologists employed by the US Veterans Health Administration (VHA), and linked these data to site-level TRI annual rates for 2013. Results We received 78 completed surveys (32% response rate). Respondents at sites that perform few or no TRIs identified increased radiation exposure as the greatest barrier while at sites that perform a high percentage of TRIs respondents identified the steep learning curve as the greatest barrier. Majorities of survey respondents at all sites rated TRI as superior on 5 of 7 criteria, including patient comfort and bleeding complications, but rated TFI as superior on procedure time and procedure success. Conclusions Even interventional cardiologists at sites that perform few or any TRIs recognized the superiority of TRI for patient comfort and safety, but rated it inferior to TFI on procedure time and technical results. Interventional cardiologists at high-TRI labs rated TRI as equivalent on procedure time and technical results. Efforts to increase TRI adoption and implementation may be more successful if they emphasize that procedure times and technical results depend on achieving proficiency. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect