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Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach

We sought to evaluate the impact of experience and proficiency with radial approach (RA) on clinical outcomes of percutaneous coronary interventions (PCI) performed via femoral approach (FA) in the “real-world” national registry. A total of 539 invasive cardiologists performing PCIs in 151 invasive...

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Autores principales: Tokarek, Tomasz, Dziewierz, Artur, Plens, Krzysztof, Rakowski, Tomasz, Zabojszcz, Michał, Dudek, Dariusz, Siudak, Zbigniew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780122/
https://www.ncbi.nlm.nih.gov/pubmed/31540442
http://dx.doi.org/10.3390/jcm8091484
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author Tokarek, Tomasz
Dziewierz, Artur
Plens, Krzysztof
Rakowski, Tomasz
Zabojszcz, Michał
Dudek, Dariusz
Siudak, Zbigniew
author_facet Tokarek, Tomasz
Dziewierz, Artur
Plens, Krzysztof
Rakowski, Tomasz
Zabojszcz, Michał
Dudek, Dariusz
Siudak, Zbigniew
author_sort Tokarek, Tomasz
collection PubMed
description We sought to evaluate the impact of experience and proficiency with radial approach (RA) on clinical outcomes of percutaneous coronary interventions (PCI) performed via femoral approach (FA) in the “real-world” national registry. A total of 539 invasive cardiologists performing PCIs in 151 invasive cardiology centers in Poland between 2014 and 2017 were included. Proficiency threshold was set at >300 PCIs during four consecutive years per individual operator. The majority of operators performed >75% of all PCIs via RA (449 (65.4%)), 143 (20.8%) in 50–75% of cases, 62 (9.0%) in 25–50% and only 33 (4.8%) invasive cardiologists were using RA in <25% of all PCIs. Operators with the highest proficiency in RA were associated with increased risk of periprocedural death, stroke and bleeding complications at access site during angiography via FA. Similarly, higher prevalence of periprocedural mortality during PCI with FA was observed in most experienced radial operators as compared to other groups. The detrimental effect of FA utilization by the most experienced radial operators was observed in both stable angina and acute coronary syndromes. Higher experience and utilization of RA might be linked to worse outcomes of PCIs performed via femoral artery in both stable and acute settings.
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spelling pubmed-67801222019-10-30 Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach Tokarek, Tomasz Dziewierz, Artur Plens, Krzysztof Rakowski, Tomasz Zabojszcz, Michał Dudek, Dariusz Siudak, Zbigniew J Clin Med Article We sought to evaluate the impact of experience and proficiency with radial approach (RA) on clinical outcomes of percutaneous coronary interventions (PCI) performed via femoral approach (FA) in the “real-world” national registry. A total of 539 invasive cardiologists performing PCIs in 151 invasive cardiology centers in Poland between 2014 and 2017 were included. Proficiency threshold was set at >300 PCIs during four consecutive years per individual operator. The majority of operators performed >75% of all PCIs via RA (449 (65.4%)), 143 (20.8%) in 50–75% of cases, 62 (9.0%) in 25–50% and only 33 (4.8%) invasive cardiologists were using RA in <25% of all PCIs. Operators with the highest proficiency in RA were associated with increased risk of periprocedural death, stroke and bleeding complications at access site during angiography via FA. Similarly, higher prevalence of periprocedural mortality during PCI with FA was observed in most experienced radial operators as compared to other groups. The detrimental effect of FA utilization by the most experienced radial operators was observed in both stable angina and acute coronary syndromes. Higher experience and utilization of RA might be linked to worse outcomes of PCIs performed via femoral artery in both stable and acute settings. MDPI 2019-09-18 /pmc/articles/PMC6780122/ /pubmed/31540442 http://dx.doi.org/10.3390/jcm8091484 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tokarek, Tomasz
Dziewierz, Artur
Plens, Krzysztof
Rakowski, Tomasz
Zabojszcz, Michał
Dudek, Dariusz
Siudak, Zbigniew
Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach
title Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach
title_full Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach
title_fullStr Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach
title_full_unstemmed Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach
title_short Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach
title_sort radial approach expertise and clinical outcomes of percutanous coronary interventions performed using femoral approach
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780122/
https://www.ncbi.nlm.nih.gov/pubmed/31540442
http://dx.doi.org/10.3390/jcm8091484
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