Operator learning curve for transradial percutaneous coronary interventions: implications for the initiation of a transradial access program in contemporary US practice. (Record no. 1078)

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fixed length control field 05178nam a22008417a 4500
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fixed length control field 150318s20142014 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1878-0938
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 24746598
245 ## - TITLE STATEMENT
Title Operator learning curve for transradial percutaneous coronary interventions: implications for the initiation of a transradial access program in contemporary US practice.
251 ## - Source
Source Cardiovascular Revascularization Medicine. 15(4):195-9, 2014 Jun.
252 ## - Abbreviated Source
Abbreviated source Cardiovasc Revasc Med. 15(4):195-9, 2014 Jun.
253 ## - Journal Name
Journal name Cardiovascular revascularization medicine : including molecular interventions
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2014
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Manufacturer FY2014
266 ## - Date added to catalog
Date added to catalog 2015-03-18
501 ## - WITH NOTE
Local holdings Available in print through MWHC library: 2002 - present
520 ## - SUMMARY, ETC.
Abstract BACKGROUND: When compared to TFA, TRA has been shown to lower bleeding and vascular complications during percutaneous coronary intervention (PCI). However, use of TRA is still low. There are limited data regarding the characteristics of TRA learning curve, especially in an era with designated TRA equipment.
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Abstract CONCLUSIONS: Adopting TRA as a default is feasible for high-volume operators without significant learning curve effects.Copyright � 2014. Published by Elsevier Inc.
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Abstract METHODS: Consecutive patients undergoing PCI in a single US center were divided into two cohorts according to vascular access approach: the last 250 TFA patients prior to the establishment of a TRA program and the initial 239 TRA patients following the establishment of a TRA program. Subgroup analysis of the TRA group, which was divided into five sequential case groups of 50 cases per group, was performed in order to assess TRA learning curve.
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Abstract OBJECTIVES: Our study aimed to assess the characteristics and outcomes of transfemoral approach (TFA) versus the initial steps of a transradial approach (TRA) program and to assess the learning curve of TRA in contemporary, US practice.
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Abstract RESULTS: Overall, the baseline characteristics of TFA vs. TRA groups were comparable. Fluoroscopy time was significantly longer during TRA procedures (18+/-11 vs. 15+/-8min, respectively, p=0.002); however, contrast use was lower during TRA procedures (161+/-72 vs. 180+/-63ml, respectively, p=0.002). In-hospital outcomes were similar between the two groups, with low frequencies of mortality, myocardial infarction, and stent thrombosis. Subanalysis of TRA group for learning curve assessment showed no major differences in patient demographics among the five subgroups. In the initial cases, more PCI was performed among non-acute cases (62% in patients 1-50 vs. 8-27% in patients 51-239, p<0.001). Despite these differences, characteristics of the treated vessels were similar between groups. There was no significant 150318 in fluoroscopy time or in the amount of iodinated contrast volume delivered. Similarly, no differences in procedural, in-hospital, and long-term outcomes were documented.
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Cardiac Catheterization/mt [Methods]
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Topical term or geographic name entry element *Catheterization, Peripheral/mt [Methods]
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Topical term or geographic name entry element *Clinical Competence
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Topical term or geographic name entry element *Coronary Artery Disease/th [Therapy]
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Topical term or geographic name entry element *Femoral Artery
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Topical term or geographic name entry element *Learning Curve
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Topical term or geographic name entry element *Percutaneous Coronary Intervention/mt [Methods]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Radial Artery
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Aged
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Cardiac Catheterization/ae [Adverse Effects]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Catheterization, Peripheral/ae [Adverse Effects]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Contrast Media/du [Diagnostic Use]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Coronary Angiography
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Topical term or geographic name entry element Coronary Artery Disease/mo [Mortality]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Coronary Artery Disease/ra [Radiography]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Coronary Thrombosis/et [Etiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Coronary Thrombosis/mo [Mortality]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element District of Columbia
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Topical term or geographic name entry element Feasibility Studies
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Female
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Hospitals, High-Volume
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Topical term or geographic name entry element Humans
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Topical term or geographic name entry element Male
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Middle Aged
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Myocardial Infarction/et [Etiology]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Myocardial Infarction/mo [Mortality]
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Topical term or geographic name entry element Percutaneous Coronary Intervention/ae [Adverse Effects]
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Topical term or geographic name entry element Percutaneous Coronary Intervention/is [Instrumentation]
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Topical term or geographic name entry element Program Development
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Topical term or geographic name entry element Radiography, Interventional
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Stents
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Topical term or geographic name entry element Time Factors
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Topical term or geographic name entry element Treatment Outcome
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Heart & Vascular Institute
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Local Authors Badr, Salem
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Local Authors Barbash, Israel M
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Local Authors Gallino, Robert
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Local Authors Kitabata, Hironori
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Local Authors Lager, Robert A
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Local Authors Loh, Joshua P
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Local Authors Minha, Sa'ar
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Local Authors Pendyala, Lakshmana K
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Local Authors Pichard, Augusto D
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Local Authors Satler, Lowell F
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Local Authors Torguson, Rebecca
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Local Authors Waksman, Ron
790 ## - Authors
All authors Badr S, Barbash IM, Gallino R, Kitabata H, Lager R, Loh JP, Minha S, Pendyala LK, Pichard AD, Satler LF, Torguson R, Waksman R
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DOI <a href="http://dx.doi.org/10.1016/j.carrev.2014.03.001">http://dx.doi.org/10.1016/j.carrev.2014.03.001</a>
Public note http://dx.doi.org/10.1016/j.carrev.2014.03.001
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 03/18/2015   24746598 24746598 03/18/2015 03/18/2015 Journal Article

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