title: Current practice of transradial approach for coronary procedures: A survey by the Italian Society of Interventional Cardiology (SICI-GISE) and the Italian Radial Club.
abstract: BACKGROUND
  Transradial approach (TRA) for percutaneous coronary procedures is associated with improved patient outcome and is being increasingly adopted worldwide. We surveyed Italian interventional cardiologists in order to take a snapshot of the current practice of TRA.
  
  
  METHODS
  A web-based questionnaire was emailed to all members of the Italian Society of Interventional Cardiology.
  
  
  RESULTS
  The survey was taken by 508 respondents. Cardiogenic shock and chronic total occlusions represented the principal limitations to TRA. Right TRA was the default approach for 81% of respondents. Both diagnostic and interventional procedures were routinely performed through 6 Fr sheaths (83% and 93%, respectively); dedicated TRA curves were used in 11% of diagnostic and in about 3% of interventional procedures. Almost 70% of the operators did not assess dual hand circulation. In case of crossover, the contralateral radial artery was the preferred site (57%). Radial artery hemostasis was mostly achieved by pneumatic bracelet (64%) and patency of the radial artery during hemostasis was ensured in 60% of cases. Pre-discharge patency of the radial artery was routinely assessed by almost 60% of respondents. For diagnostic procedures, adequate heparin anticoagulation (5000IU) was only given by 45% of operators. Most respondents believed that TRA is associated with greater radiation exposure for both the patient (82%) and the operator (98%) as compared to transfemoral approach.
  
  
  CONCLUSIONS
  This survey provides contemporary data about the adoption of TRA in Italy and gives interesting insights about several technical and clinical issues related to the practice of this vascular approach for coronary procedures.
authors.affiliation: Interventional Cardiology Unit, Sandro Pertini Hospital, Roma, Italy. Electronic address: stefanorigattieri@yahoo.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rigattieri
authors.affiliation: Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Orazio
authors.initials: O
authors.lastname: Valsecchi
authors.affiliation: Interventional Cardiology Unit, Sandro Pertini Hospital, Roma, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciahbasi
authors.affiliation: Cardiology Department, Ospedale degli Infermi, Rivoli, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomassini
authors.affiliation: Cardiology Unit, Azienda USL Toscana Sudest, Grosseto, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Limbruno
authors.affiliation: Interventional Cardiology Unit, Anthea Hospital, GVM Care & Research, Bari, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Marchese
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: La Manna
authors.affiliation: Cardiovascular Department, Cardarelli Hospital, Napoli, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Mauro
authors.affiliation: Cardiology Department, Ospedale degli Infermi, Rivoli, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Varbella
authors.affiliation: Department of Cardiology, Fondazione Toscana "Gabriele Monasterio", Ospedale del Cuore, Massa, Italy.
authors.forename: Segio
authors.initials: S
authors.lastname: Berti
authors.affiliation: Cardiology Unit, Ospedale G.B. Morgagni-L. Pierantoni, Forlì, Italy.
authors.forename: Fabio F
authors.initials: FF
authors.lastname: Tarantino
authors.affiliation: Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000639:trends*; D062906:Cardiac Catheters / Q000639:trends; D000066491:Clinical Decision-Making; D004867:Equipment Design; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D016273:Occupational Exposure; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D017534:Radial Artery / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D000069079:Radiation Exposure; D015641:Radiography, Interventional / Q000639:trends; D012307:Risk Factors; D012955:Societies, Medical
keywords: Cardiac catheterization; Survey research; Transradial approach