Complication rate of venous access procedures performed by a radiology practitioner assistant compared with interventional radiology physicians and supervised trainees.
OBJECTIVE
To compare venous access complication rates associated with procedures performed by radiology practitioner assistants (RPAs) versus interventional radiology (IR) faculty members, IR fellows, and radiology residents.


METHODS
A retrospective review of venous access procedures in the IR department for 12 consecutive months at a single university hospital was performed. Procedural primary operators included 12 radiology residents, two IR fellows, four IR faculty members, and one board-certified RPA with 2 years of university training. Data examined included immediate and short-term complications separated into major and overall categories.


RESULTS
A total of 2093 venous access procedures were performed. The RPA performed 670 procedures (temporary central venous catheter placement, n = 274; peripherally inserted central catheter, n = 67; venous access catheter change, n = 99; venous port placement, n = 126; tunneled central venous catheter placement, n = 39; catheter check, n = 32; and venous explant, n = 43). Similar procedure ratios were noted with faculty members, fellows, and residents. Procedures by the RPA had a major complication rate of 0.29% and an overall complication rate of 0.89%. Four IR faculty members performed 291 procedures, with no major complications and an overall complication rate of 1.71%. Two IR fellows performed 562 procedures, with a major complication rate of 0.35% and an overall complication rate of 1.06%. Twelve residents performed 570 procedures, with a major complication rate of 0.52% (range, 0%-2.46%) and an overall complication rate of 1.39% (range, 0%-3.70%). No significant difference was found among groups (P = .7).


CONCLUSIONS
A properly trained and monitored RPA can safely perform selected venous access procedures with complication rates equal to those of IR faculty members, fellows, and residents.
Department of Radiology, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, Arkansas 72205, USA. benhamjosephr@uams.edu
Joseph R
JR
Benham
William C
WC
Culp
Lonnie B
LB
Wright
Timothy C
TC
McCowan
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004869:Equipment Safety; D005257:Fellowships and Scholarships / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D010823:Physician Assistants / Q000193:education / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D015642:Radiology, Interventional / Q000193:education*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D000078329:Workforce