Identifying factors that predict the choice and success rate of radial artery catheterisation in contemporary real world cardiology practice: a sub-analysis of the PREVAIL study data.
To assess: the reasons behind an operator choosing to perform radial artery catheterisation (RAC) as against femoral arterial catheterisation, and to explore why RAC may fail in the real world.



A pre-determined analysis of PREVAIL study database was performed. Relevant data were collected in a prospective, observational survey of 1,052 consecutive patients undergoing invasive cardiovascular procedures at nine Italian hospitals over a one month observation period. By multivariate analysis, the independent predictors of RAC choice were having the procedure performed: (1) at a high procedural volume centre; and (2) by an operator who performs a high volume of radial procedures; clinical variables played no statistically significant role. RAC failure was predicted independently by (1) a lower operator propensity to use RAC; and (2) the presence of obstructive peripheral artery disease. A 10-fold lower rate of RAC failure was observed among operators who perform RAC for > 85% of their personal caseload than among those who use RAC < 25% of the time (3.8% vs. 33.0%, respectively); by receiver operator characteristic (ROC) analysis, no threshold value for operator RAC volume predicted RAC failure.



A routine RAC in all-comers is superior to a selective strategy in terms of feasibility and success rate.
Pristipino
Christian
C
San Filippo Neri Hospital, Rome, Italy. pristipino@gmail.com
Roncella
Adriana
A
Trani
Carlo
C
Nazzaro
Marco S
MS
Berni
Andrea
A
Di Sciascio
Germano
G
Sciahbasi
Alessandro
A
Musarò
Salvatore Donato
SD
Mazzarotto
Pietro
P
Gioffrè
Gaetano
G
Speciale
Giulio
G
D006328:Cardiac Catheterization / Q000379:methods*; D002755:Choice Behavior; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D011446:Prospective Studies; D017534:Radial Artery