TCT-787 Transradial Versus Transfemoral Access for Cardiac Catheterization: A Nationwide Survey of Training Preferences, Expertise, and Comfort Among Cardiovascular Fellows and Teaching Faculty

• Published in: Journal of the American College of Cardiology Vol. 74; no. 13; p. B771
• Main Authors: Syed, Mubbasher, Changal, Khalid Hamid, Atari, Ealla, Eltahawy, Ehab
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 01-10-2019; Elsevier Limited
• Subjects: Aorta; Boring tools; Cannulation; Cardiac catheterization; Cardiology; Cardiovascular disease; Catheterization; Catheters; Exposure; Femur; Patient satisfaction; Preservation; Reperfusion; Training; United States > US
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2019.08.931

Traditionally, PCI has been performed via transfemoral access (TFA) because of large arterial size, allowing easier cannulation of the artery, manipulation of catheters, simultaneous placement of intra-aortic balloon pump and Impella device, and adequate reperfusion time. The purpose of this study was to assess the current training preferences, expertise, and comfort with TFA and TRA among cardiovascular (CV) training fellows and teaching faculty in the United States.Methods An online questionnaire to assess current training, preferences, and ability for access options was sent out to 239 academic general cardiovascular and 160 interventional cardiology training programs in the United States. The reasons provided by fellows and faculty members for their respective preferences were associated complication profile (75.4% vs. 67.3%; p = 0.35), personal experience (62.3% vs. 32.6%; p = 0.002), ability to maneuver (8.9% vs. 34.7%; p = 0.001), preservation of radial conduits (0% vs. 8.1%; p = 0.04), ability to upsize to larger bore (3.2% vs. 24.4%; p = 0.001), ease of closure (68.8% vs. 57.1%, p = 0.2), patient satisfaction (85.2% vs. 63.2%; p = 0.002), training center radial-first policy (50.8% vs. 26.5%; p = 0.01), high exposure during residency to radial arterial lines (19.6% vs. 2%; p = 0.001), and low exposure during residency to femoral arterial lines (21.3% vs. 0%; p = 0.001.