Dave Fornell, DAIC Editor

Dave Fornell, Editor DAIC

Blog | Dave Fornell, DAIC Editor | March 06, 2013

The Radial Access Adoption Report Card

Over the past decade in the United States, there has been growing interest in transradial artery percutaneous access as a way to significantly reduce bleeding rates and access site complications. However, adoption in the United States has been slow compared to other parts of the world, partly due to lack of training in interventional programs until recently. In articles and sessions at various cardiology conferences, I have heard varying U.S. adoption rate percentages.  

One of the biggest advocates for expanding radial access is Sunil V. Rao, M.D., FACC, assistant professor of medicine at Duke University Medical Center and director of the cardiac cath lab at the Durham VA Medical Center, Durham, N.C. He asked the same question about U.S. radial access usage and found it accounted for 3 percent of cath lab access in his 2008 study[1] of the American College of Cardiology’s CathPCI Registry of the National Cardiovascular Data Registry (NCDR). The CathPCI Registry collects data from about 85 percent of the cardiac cath labs in the United States.

Since 2008, there has been a big push from radial evangelists such as Rao and others to spread the word about the benefits of radial access.  That message has been amplified in recent years in an era of reduced reimbursements and healthcare reform forcing hospitals to look for new ways to reduce costs, including reducing hospital length of stay and complications.

An updated NCDR snapshot of radial access between January 2010 and June 2011 was published in December 2012.  The study showed radial access usage rose to 8.3 percent[2], based on a review of 1.1 million patients undergoing diagnostic cardiac catheterization and 941,248 undergoing percutaneous coronary intervention (PCI). 

This growth rate combined with the introduction of radial training programs in recent years has some experts now predicting a 15 percent radial access usage rate by 2014. 

I wrote a column three years ago that asked why radial access is not more widely used if study after study shows it can slash complication rates, increase patient safety and reduce length of stay and nursing time?  The question I posed then still stands. Out of all the columns and articles ever written in DAIC, that column generated, by far, the most reader comments we ever received. DAIC’s most read website content also includes several transradial access stories in the top 20 articles for 2012. 

One major change that could spur radial’s increased usage would be recognition of its benefits by the Centers for Medicare and Medicaid Services (CMS) by offering higher reimbursements for radial over femoral access. From the level of evidence seen in studies, this increased cost would be offset downstream by greatly lowering the costs to treat complications. 

 

References: 

 

1. Sunil V. Rao, Fang-Shu Ou, Tracy Y. Wang, et al. “Trends in the Prevalence and Outcomes of Radial and Femoral Approaches to Percutaneous Coronary Intervention.” J Am Coll Cardiol Intv. 2008;1(4):379-386. doi:10.1016/j.jcin.2008.05.007.

2. Gregory J. Dehmer, Douglas Weaver, Matthew T. Roe, et al. “A Contemporary View of Diagnostic Cardiac Catheterization and Percutaneous Coronary Intervention in the United States A Report From the CathPCI Registry of the National Cardiovascular Data Registry, 2010 Through June 2011.” J Am Coll Cardiol. 2012;60(20):2017-2031. doi:10.1016/j.jacc.2012.08.966

Related Content

Sponsored Content | Videos | Cath Lab

Advancements in analytics and data visualizations are helping to streamline operations and improve productivity at cath ...

Home January 13, 2022
Home
News | Cath Lab

January 4, 2022 — The U.S. Food and Drug Administration (FDA) has authorized marketing of the first laser-based device ...

Home January 04, 2022
Home
News | Cath Lab

December 14, 2021 — RSIP Vision, a medical imaging company applying advanced artificial intelligence (AI) and computer ...

Home December 14, 2021
Home
Feature | Cath Lab

November 15, 2021 — RealView Imaging Ltd. recently received FDA 510(k) clearance for its Holoscope-i holographic system ...

Home November 15, 2021
Home
News | Cath Lab

November 10, 2021 — Shockwave Medical a pioneer in the development of Intravascular Lithotripsy (IVL) to treat severely ...

Home November 10, 2021
Home
News | Cath Lab

November 10, 2021 — Philips Healthcare announced North American availability of new innovations in its portfolio of ...

Home November 10, 2021
Home
News | Cath Lab

October 6, 2021 — Boston Scientific Corp. announced it entered into a definitive agreement to acquire Baylis Medical ...

Home October 06, 2021
Home
News | Cath Lab

September 21, 2021 — Medtronic is recalling its Pipeline Flex Embolization Device and Pipeline Flex Embolization Device ...

Home September 21, 2021
Home
Feature | Cath Lab | By Aaron Detate and Lars Thording

In the electrophysiology (EP) lab, hundreds of thousands of used devices are sent to reprocessors every year to get ...

Home September 14, 2021
Home
News | Cath Lab

July 22, 2021 — Medis Medical Imaging is partnering with CORRIB Core Lab and Sinomed in randomized clinical trial of ...

Home July 22, 2021
Home
Subscribe Now