In the United States, radial artery (wrist) catheterization is performed in the minority of diagnostic angiograms and cardiac stenting procedures despite the benefits it offers to patients in terms of reduced complications and faster mobility after the procedure. Now, new research from the Perelman School of Medicine at the University of Pennsylvania, the University of Washington Medical Center, and the University of Pittsburgh School of Medicine, indicates that radial access may offer a significant cost savings benefit to hospitals. The findings are published online first in Circulation: Cardiovascular Quality and Outcomes.
"Radial artery access is the primary mode of access for catheterization procedures in Europe, Canada, and Japan, but has not gained widespread acceptance in the United States, possibly stemming from concerns about increases in procedure time, radiation exposure, and access failure in patients," said Matthew D. Mitchell, PhD, senior research analyst in the Center for Evidence-based Practice at Penn Medicine. "This study suggests that the adoption of radial catheterization could be a more viable option for many hospitals and health systems, lowering costs and reducing complications for patients."
In the current study, researchers statistically combined the findings from 14 previously published studies that compared outcomes from coronary angiograms and stenting procedures performed through the radial artery versus the femoral artery. They then inserted these combined findings into a cost-benefit simulation model designed to estimate the average cost of care for these procedures. The model took into account differences between the radial and femoral approach in terms of procedure and hemostasis time, costs of repeating the catheterization at the alternate site if the first catheterization failed, and the inpatient hospital costs associated with complications from the procedure. The researchers found the radial approach cost hospitals $275 less per patient than the femoral approach. These findings were robust under all conditions tested in the simulated model.
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