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 journalArticle

1 Citation (Scopus)

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)
JournalCardiovascular Revascularization Medicine
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Percutaneous Coronary Intervention
Thigh
Angiography
Punctures
Practice Guidelines
Cardiogenic Shock
Palpation
Fluoroscopy
Postal Service
Femoral Artery
Coronary Angiography
Needles
Physicians

Keywords

  • PCI
  • Stent
  • Survey
  • Transfemoral

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Influence of operator experience and PCI volume on transfemoral access techniques : A collaboration of international cardiovascular societies. / Nelson, Daniel W.; Damluji, Abdulla A.; Patel, Nish; Valgimigli, Marco; Windecker, Stephan; Byrne, Robert; Nolan, James; Patel, Tejas; Brilakis, Emmanouil; Banerjee, Subhash; Mayol, Jorge; Cantor, Warren J.; Alfonso, Carlos E.; Rao, Sunil V.; Moscucci, Mauro; Cohen, Mauricio G.

In: Cardiovascular Revascularization Medicine, 01.01.2018.

Research output: Contribution to journalArticle

Nelson, DW, Damluji, AA, Patel, N, Valgimigli, M, Windecker, S, Byrne, R, Nolan, J, Patel, T, Brilakis, E, Banerjee, S, Mayol, J, Cantor, WJ, Alfonso, CE, Rao, SV, Moscucci, M & Cohen, MG 2018, 'Influence of operator experience and PCI volume on transfemoral access techniques: A collaboration of international cardiovascular societies', Cardiovascular Revascularization Medicine. https://doi.org/10.1016/j.carrev.2017.12.013
Nelson, Daniel W. ; Damluji, Abdulla A. ; Patel, Nish ; Valgimigli, Marco ; Windecker, Stephan ; Byrne, Robert ; Nolan, James ; Patel, Tejas ; Brilakis, Emmanouil ; Banerjee, Subhash ; Mayol, Jorge ; Cantor, Warren J. ; Alfonso, Carlos E. ; Rao, Sunil V. ; Moscucci, Mauro ; Cohen, Mauricio G. / Influence of operator experience and PCI volume on transfemoral access techniques : A collaboration of international cardiovascular societies. In: Cardiovascular Revascularization Medicine. 2018.
@article{abc555c635af4f879a7ed6e90e827e25,
title = "Influence of operator experience and PCI volume on transfemoral access techniques: A collaboration of international cardiovascular societies",
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.",
keywords = "PCI, Stent, Survey, Transfemoral",
author = "Nelson, {Daniel W.} and Damluji, {Abdulla A.} and Nish Patel and Marco Valgimigli and Stephan Windecker and Robert Byrne and James Nolan and Tejas Patel and Emmanouil Brilakis and Subhash Banerjee and Jorge Mayol and Cantor, {Warren J.} and Alfonso, {Carlos E.} and Rao, {Sunil V.} and Mauro Moscucci and Cohen, {Mauricio G.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.carrev.2017.12.013",
language = "English (US)",
journal = "Cardiovascular Revascularization Medicine",
issn = "1553-8389",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Influence of operator experience and PCI volume on transfemoral access techniques

T2 - A collaboration of international cardiovascular societies

AU - Nelson, Daniel W.

AU - Damluji, Abdulla A.

AU - Patel, Nish

AU - Valgimigli, Marco

AU - Windecker, Stephan

AU - Byrne, Robert

AU - Nolan, James

AU - Patel, Tejas

AU - Brilakis, Emmanouil

AU - Banerjee, Subhash

AU - Mayol, Jorge

AU - Cantor, Warren J.

AU - Alfonso, Carlos E.

AU - Rao, Sunil V.

AU - Moscucci, Mauro

AU - Cohen, Mauricio G.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - PCI

KW - Stent

KW - Survey

KW - Transfemoral

UR - http://www.scopus.com/inward/record.url?scp=85040336939&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040336939&partnerID=8YFLogxK

U2 - 10.1016/j.carrev.2017.12.013

DO - 10.1016/j.carrev.2017.12.013

M3 - Article

C2 - 29331437

AN - SCOPUS:85040336939

JO - Cardiovascular Revascularization Medicine

JF - Cardiovascular Revascularization Medicine

SN - 1553-8389

ER -