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Radial artery access favored over femoral route in cost-benefit analysis
Radial artery access for coronary angiography and intervention may provide a significant cost savings benefit to hospitals, according to results of a meta-analysis published in Circulation: Cardiovascular Quality and Outcomes.
Researchers at the Perelman School of Medicine at the University of Pennsylvania, University of Washington Medical Center, and University of Pittsburgh School of Medicine completed a systematic review of findings from 14 previously published studies that compared outcomes from radial artery catheterizations with outcomes from femoral artery catheterizations. The researchers then used a cost-benefit simulation model to analyze the findings, taking into account procedure and hemostasis time, costs of repeating the catheterization at the alternate site if the first catheterization failed, and inpatient hospital costs associated with complications from the procedure.
Craig A. Umscheid, MD
Photo credit: Penn Medicine;
reprinted with permission.
Overall, the radial approach cost hospitals $275 less per patient, compared with the femoral approach. Radial access was favored under all conditions tested, according to the researchers.
The analysis also revealed no differences in procedure success rates or major adverse CV events between the two approaches. In addition, the radial approach took, on average, only 1 minute and 23 seconds longer than the femoral approach.
The researchers note that although the radial technique may be associated with a learning curve for many cardiologists in the United States, compared to the femoral artery technique, the additional training required and widespread adoption of radial catheterization could result in substantial savings for the US health care system, according to a press release from the University of Pennsylvania.
“The savings from radial catheterization may not be as significant in sites with very low femoral access complications or excessively long radial catheterization times,” Craig A. Umscheid, MD, assistant professor of medicine and epidemiology, director of the Penn Medicine Center for Evidence-based Practice, stated in the release. “But, overall, our study demonstrated that the savings from reduced vascular complications outweighed the increased costs of longer procedure times and access failure associated with radial artery access by a large margin.”
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Disclosure: The study was funded by a NIH/National Center for Research Resources grant and a National Institute of General Medical Sciences Models of Infectious Disease Agent Study grant.