Last updated on 11/09/2010 at 06:20.
For interventional/endovascular procedures, inserting a catheter through the radial artery in the arm appears to be linked to a lower rate of bleeding complications than the standard route through the femoral artery in the groin. Currently for all catheter procedures in the United States, the radial artery is used for access only 1-3% of the time. In other countries, the radial artery is used for access in catheter procedures 50-90% of the time.
The benefits of Transradial Interventions (TRI) vs. Transfemoral Interventions (TFI) for interventional/endovascular procedures can be summarized as:
- Reduced access site bleeding complications by 75% compared to femoral access
- Reduced cost of interventional procedures because of reduced device cost, reduced complications, reduced length of hospital stay
- Earlier mobility of patients
- Reduced length of hospital stay
- Earlier return to productivity of patients after a procedure
- Reduced intensity of post-procedure care
- Enables interventional procedures to be completed as an outpatient
- More comfortable for patients
- Better for women and other groups at higher risk for bleeding complications during catheter-based procedures
The goals of the Patient Medical Association regarding TRI include:
- Position TRI as a healthcare reform initiative that can save money and improve clinical outcomes
- Increase TRI utilization during catheter procedures (PCI and peripherally) to 50% in the USA by 2020
- Advocate for CMS and insurance providers to provide:
- Higher reimbursements for TRI vs TFI
- Decreased reimbursements for treatment of bleeding complications arising from TFI
- Fairer compensation for outpatient catheter-based procedures to compensate for hospitals losing reimbursements for an overnight hospital stay
- Advocate for TRI to become a Class I recommendation in established guidelines for interventional/endovascular procedures
- Advocate for an NIH Consensus Development Program (CDP) to address the issue of TRI vs. TFI
- Advocate for TRI utilization in peripheral procedures
- Advocate for medical device companies to develop catheter-based devices for use in TRI
- Educate patients regarding the benefits of TRI and urge them to request it during interventional procedures (including partnerships with advocacy groups like AARP and ASA - American Seniors Association)
- Work with societies to establish guidelines for TRI training courses
- Provide TRI training to all interventional/endovascular fellows starting in 2011
- Establish a TRI training infrastructure to accommodate at least 1,000 physicians and staff per year
All patients undergoing catheter-based procedures are encouraged to ask their physicians about the benefits of TRI vs TFI to determine if their catheter procedure would be safer and more comfortable for them if a radial approach were to be used.
