Influence of operator experience and PCI volume on transfemoral access techniques: A collaboration of international cardiovascular societies

Daniel W. Nelson, Abdulla A. Damluji, Nish Patel, Marco Valgimigli, Stephan Windecker, Robert Byrne, James Nolan, Tejas Patel, Emmanouil Brilakis, Subhash Banerjee, Jorge Mayol, Warren J. Cantor, Carlos E. Alfonso, Sunil V. Rao, Mauro Moscucci, Mauricio G. Cohen

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Introduction: Transfemoral access (TFA) is widely used for coronary angiography and percutaneous coronary intervention (PCI). The influence of operator age, gender, experience, and procedural volume on performance of femoral arterial access has not been studied. Methods: A survey instrument was developed and distributed via e-mail from professional societies to interventional cardiologists worldwide from March to December 2016. Results: A total of 988 physicians from 88 countries responded to the survey. TFA is the preferred approach for patients with cardiogenic shock, left main or bifurcation PCI, and procedures with mechanical circulatory support. Older (< 50 years: 56.4%; ≥ 50 years: 66.8%, p < 0.0039) and high PCI volume operators (< 100 PCI: 57.3%; 100–299 PCI: 58.7%; ≥ 300 PCI: 64.3%, p < 0.134) preferred palpation only without imaging (fluoroscopy or ultrasound (US)) for TFA. Most respondents preferred not to use micropuncture needle to puncture the femoral artery. Older (≥ 50 years: 64.4%; < 50 years: 71.5%, p < 0.04) and high PCI volume operators (≥ 300 PCI: 64.1%; 100–299 PCI: 72.6%; < 100 PCI: 67.9%, p < 0.072) tended not to perform femoral angiography (FA). Of those performing FA, the majority opted to do it at the end of the procedure. Conclusion: Despite best practice guideline recommendations, older and high PCI volume interventional cardiologists prefer not to use imaging for femoral access or perform femoral angiography during TF procedures. These data highlight opportunities to further reduce TFA complications.

Original languageEnglish (US)
Pages (from-to)143-150
Number of pages8
JournalCardiovascular Revascularization Medicine
Volume19
Issue number2
DOIs
StatePublished - Mar 2018

Keywords

  • PCI
  • Stent
  • Survey
  • Transfemoral

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Influence of operator experience and PCI volume on transfemoral access techniques: A collaboration of international cardiovascular societies'. Together they form a unique fingerprint.

Cite this