title: A single center multioperator initial experience of 4,195 patients at a primary radial intervention program in a tertiary level center.
abstract: BACKGROUND
  There has been an increase the acceptability and the number of the procedures via the radial approach. We present our experience pertaining to the clinical characteristics, procedural details and post procedural outcome of patients undergoing radial artery access, coronary angiographies over a period of 4 years at a primary care tertiary level center.
  
  
  METHODS
  A retrospective analysis of all the coronary artery procedures during the last 4 years was done and the various parameters related to these procedures noted.
  
  
  RESULTS
  In 4195 procedures performed, success in radial artery procedures was achieved in 3975 (94.8%) procedures. The average puncture time and total procedure time was 9.5 + 3 min (min) and 15 + 2.5 min in the initial 500 patients, whereas the times taken in the final 695 patients were just 1.5 + 0.5 min and 3.0 + 1.5 min respectively. The total fluoroscopy time was not significantly different among the groups, when performed by an operator with training in the femoral route for angiography. Cardiology fellows needed more fluoroscopy time when mastering the radial route. Crossover of access sites was seen in 220 patients (5.2%).
  
  
  CONCLUSIONS
  After 100 procedures, radial access coronary angiographies take less than 4.5 min, with first attempt radial artery access and negligible complication rates. Prior experience of coronary angiography helps in the reduction of fluoroscopy time during the learning curve.
authors.affiliation: Professor & Head of Department, Post Graduate Department of Cardiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan 301009, India.
authors.forename: Rajendra K
authors.initials: RK
authors.lastname: Gokhroo
authors.affiliation: Principal and Controller, Professor & Head of Department, Post Graduate Department of Cardiology, R.N.T Medical College, Udaipur, Rajasthan 313001, India.
authors.forename: Satish K
authors.initials: SK
authors.lastname: Kaushik
authors.affiliation: Fellow Cardiology, Post Graduate Department of Cardiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan 301009, India. Electronic address: drrajendragokhroo@yahoo.in.
authors.forename: Deepak
authors.initials: D
authors.lastname: Padmanabhan
authors.affiliation: Fellow Cardiology, Post Graduate Department of Cardiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan 301009, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Bisht
authors.affiliation: Fellow Cardiology, Post Graduate Department of Cardiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan 301009, India.
authors.forename: Sajal
authors.initials: S
authors.lastname: Gupta
mesh_terms: D000367:Age Factors; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D017534:Radial Artery; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D062606:Tertiary Care Centers / Q000458:organization & administration
keywords: Coronary angiography; Femoral artery access; Radial artery access