Khalid Changal1, Mubbasher Ameer Syed2, Ealla Atari3, Salik Nazir2, Sameer Saleem4, Sajjad Gul5, F N U Salman6, Asad Inayat7, Ehab Eltahawy8. 1. Department of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA. khalid.changal@utoledo.edu. 2. Department of Cardiovascular Medicine, University of Toledo, Toledo, OH, USA. 3. College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA. 4. Department of Cardiovascular Medicine, University of Kentucky, Bowling Green, USA. 5. Internal Medicine, St. Francis Medical Center, University of Illinois at Peoria, Peoria, USA. 6. Internal Medicine, Mercy St. Vincent Medical Center, Toledo, OH, USA. 7. Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan. 8. Professor and Program Director of Cardiovascular Medicine and Interventional Cardiology, University of Toledo, 3000 Arlington Ave., MS 1118, Toledo, 43614, OH, USA. ehab.eltahawy2@utoledo.edu.
Abstract
BACKGROUND: The objective was to assess current training preferences, expertise, and comfort with transfemoral access (TFA) and transradial access (TRA) amongst cardiovascular training fellows and teaching faculty in the United States. As TRA continues to dominate the field of interventional cardiology, there is a concern that trainees may become less proficient with the femoral approach. METHODS: A detailed questionnaire was sent out to academic General Cardiovascular and Interventional Cardiology training programs in the United States. Responses were sought from fellows-in-training and faculty regarding preferences and practice of TFA and TRA. Answers were analyzed for significant differences between trainees and trainers. RESULTS: A total of 125 respondents (75 fellows-in-training and 50 faculty) completed and returned the survey. The average grade of comfort for TFA, on a scale of 0 to 10 (10 being most comfortable), was reported to be 6 by fellows-in-training and 10 by teaching faculty (p < 0.001). TRA was the first preference in 95% of the fellows-in-training compared to 69% of teaching faculty (p 0.001). While 62% of fellows believed that they would receive the same level of training as their trainers by the time they graduate, only 35% of their trainers believed so (p 0.004). CONCLUSION: The shift from TFA to radial first has resulted in significant concern among cardiovascular fellows-in training and the faculty regarding training in TFA. Cardiovascular training programs must be cognizant of this issue and should devise methods to assure optimal training of fellows in gaining TFA and managing femoral access-related complications.
BACKGROUND: The objective was to assess current training preferences, expertise, and comfort with transfemoral access (TFA) and transradial access (TRA) amongst cardiovascular training fellows and teaching faculty in the United States. As TRA continues to dominate the field of interventional cardiology, there is a concern that trainees may become less proficient with the femoral approach. METHODS: A detailed questionnaire was sent out to academic General Cardiovascular and Interventional Cardiology training programs in the United States. Responses were sought from fellows-in-training and faculty regarding preferences and practice of TFA and TRA. Answers were analyzed for significant differences between trainees and trainers. RESULTS: A total of 125 respondents (75 fellows-in-training and 50 faculty) completed and returned the survey. The average grade of comfort for TFA, on a scale of 0 to 10 (10 being most comfortable), was reported to be 6 by fellows-in-training and 10 by teaching faculty (p < 0.001). TRA was the first preference in 95% of the fellows-in-training compared to 69% of teaching faculty (p 0.001). While 62% of fellows believed that they would receive the same level of training as their trainers by the time they graduate, only 35% of their trainers believed so (p 0.004). CONCLUSION: The shift from TFA to radial first has resulted in significant concern among cardiovascular fellows-in training and the faculty regarding training in TFA. Cardiovascular training programs must be cognizant of this issue and should devise methods to assure optimal training of fellows in gaining TFA and managing femoral access-related complications.
Entities:
Keywords:
Campeau radial paradox; Femoral access; Radial access; Radial first
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