Radial access for percutaneous coronary procedure: relationship between operator expertise and complications
Objective The aim of this study was to investigate (1) whether the learning curve of new catheterization laboratory operators increases the incidence of complications of transradial access during percutaneous coronary interventions and (2) whether manual compression with a two-step approach is safe...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2018-06-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-17-210.pdf |
| _version_ | 1797895643174273024 |
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| author | Simona Susanu Marco Angelillis Cristina Giannini Rossella Binella Anna Matteoni Rita Bellucci Sandro Balestri Nicola Ferrara Federico Falchi Giuliano Micheletti Anna Sonia Petronio |
| author_facet | Simona Susanu Marco Angelillis Cristina Giannini Rossella Binella Anna Matteoni Rita Bellucci Sandro Balestri Nicola Ferrara Federico Falchi Giuliano Micheletti Anna Sonia Petronio |
| author_sort | Simona Susanu |
| collection | DOAJ |
| description | Objective The aim of this study was to investigate (1) whether the learning curve of new catheterization laboratory operators increases the incidence of complications of transradial access during percutaneous coronary interventions and (2) whether manual compression with a two-step approach is safe and efficient for radial access hemostasis. Methods We performed a prospective study with all consecutive patients who underwent a coronary diagnostic or intervention procedure with radial access. The primary end point was a composite of pulseless radial artery of the wrist and hematoma evaluated after 24 hours. The secondary end point of efficacy was defined as the presence of bleeding or hematoma after 30 seconds. Results From March 2016 to June 2016, 150 consecutive patients, of whom 147 underwent coronary angiography and/or percutaneous coronary intervention through radial access, were included in the present study. The primary end point was present in 33%, but pulseless radial artery of the wrist was present only in 5.3%. We found that the incidence of primary end point was statistically different according to the number of puncture attempts, with a cutoff of two punctures with blood. The secondary end point of safety was present only in 4.7% of the cases. Conclusion Radial access is feasible and safe even if performed by training physicians. Manual compression with early evaluation after 30 seconds is a safe technique for managing the radial access after sheath removal. |
| first_indexed | 2024-04-10T07:30:06Z |
| format | Article |
| id | doaj.art-b8c16612a83e410fad9a74a4e12b2ed4 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:30:06Z |
| publishDate | 2018-06-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-b8c16612a83e410fad9a74a4e12b2ed42023-02-24T01:21:07ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252018-06-0152959910.15441/ceem.17.210188Radial access for percutaneous coronary procedure: relationship between operator expertise and complicationsSimona Susanu0Marco AngelillisCristina Giannini1Rossella Binella2Anna Matteoni3Rita Bellucci4Sandro Balestri5Nicola Ferrara6Federico Falchi7Giuliano Micheletti8Anna Sonia Petronio9 Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, Italy Catheterization Laboratory, University of Pisa, Pisa, ItalyObjective The aim of this study was to investigate (1) whether the learning curve of new catheterization laboratory operators increases the incidence of complications of transradial access during percutaneous coronary interventions and (2) whether manual compression with a two-step approach is safe and efficient for radial access hemostasis. Methods We performed a prospective study with all consecutive patients who underwent a coronary diagnostic or intervention procedure with radial access. The primary end point was a composite of pulseless radial artery of the wrist and hematoma evaluated after 24 hours. The secondary end point of efficacy was defined as the presence of bleeding or hematoma after 30 seconds. Results From March 2016 to June 2016, 150 consecutive patients, of whom 147 underwent coronary angiography and/or percutaneous coronary intervention through radial access, were included in the present study. The primary end point was present in 33%, but pulseless radial artery of the wrist was present only in 5.3%. We found that the incidence of primary end point was statistically different according to the number of puncture attempts, with a cutoff of two punctures with blood. The secondary end point of safety was present only in 4.7% of the cases. Conclusion Radial access is feasible and safe even if performed by training physicians. Manual compression with early evaluation after 30 seconds is a safe technique for managing the radial access after sheath removal.http://www.ceemjournal.org/upload/pdf/ceem-17-210.pdfvascular accessmanual compressionattending physiciancardiology training |
| spellingShingle | Simona Susanu Marco Angelillis Cristina Giannini Rossella Binella Anna Matteoni Rita Bellucci Sandro Balestri Nicola Ferrara Federico Falchi Giuliano Micheletti Anna Sonia Petronio Radial access for percutaneous coronary procedure: relationship between operator expertise and complications Clinical and Experimental Emergency Medicine vascular access manual compression attending physician cardiology training |
| title | Radial access for percutaneous coronary procedure: relationship between operator expertise and complications |
| title_full | Radial access for percutaneous coronary procedure: relationship between operator expertise and complications |
| title_fullStr | Radial access for percutaneous coronary procedure: relationship between operator expertise and complications |
| title_full_unstemmed | Radial access for percutaneous coronary procedure: relationship between operator expertise and complications |
| title_short | Radial access for percutaneous coronary procedure: relationship between operator expertise and complications |
| title_sort | radial access for percutaneous coronary procedure relationship between operator expertise and complications |
| topic | vascular access manual compression attending physician cardiology training |
| url | http://www.ceemjournal.org/upload/pdf/ceem-17-210.pdf |
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