Our last blog focused on the rising trend towards performing percutaneous coronary intervention (PCI) transradially, or vascular catheterization via wrist access, in the United States. As medical professionals continue looking for ways to improve patient care, the adoption of transradial access (TRA) grows because of the well-documented patient benefits. There is significant evidence that TRA offers clinical benefits for patients, including fewer major bleeding and vascular complications, reduced incidence of other adverse events and faster discharge1.
For many years, percutaneous coronary intervention (PCI) was performed almost exclusively via transfemoral (groin) access. Over the years, there has been a significant trend towards transradial (wrist) access. Transradial access (TRA) is considered the standard in many parts of the world but in the United States, adoption has been slower. That said, the percentage of procedures that are performed radially in the US has increased steadily over the last decade, reaching approximately 30% in current practice.
The topic of cath lab radiation safety has been on the rise in recent years. In 2015 alone, there were 42 publications related to the occupational hazards of working with interventional fluoroscopy, an amount double that of the year prior. Some risks have been widely known for a while including radiation-induced cancer, cataracts, and orthopedic strain from heavy lead protective equipment. Others have been uncovered only more recently including accelerated vascular aging, cognitive impairment, hypertension, and left-sided brain tumors.
Earlier this month, the second annual San Diego Cardiovascular Interventions (SDCI) conference was held in La Jolla, CA. The two-day meeting focused on robotics for coronary and peripheral interventions and CHIP, or Complex High-Risk (and Indicated) Patients.
Robotic therapy is changing how procedures are performed in the cath lab. A successful robotics program will not only enable cath lab teams to provide a high level of patient care but can also significantly reduce procedure-related health risks among interventional clinicians working in the cardiac cath lab. However, building a successful program requires a clearly identified team, commitment from the institution, and a focus on clinical training.
Over the past several years, as more data is published, the discussion about the harmful health effects of chronic, low-level exposure to ionizing radiation among interventional cardiologists and their teams has become more prominent. Now, another study on occupational health risks in the cath lab receiving national media attention has called attention to this issue and highlighted additional risks.
Earlier this month, the Society for Cardiovascular Angiography and Interventions (SCAI) held their annual Scientific Sessions in Orlando, FL. The meeting featured the presentations and discussions on the latest clinical data in interventional cardiology and emphasized the mission to "Save and Enhance Lives." Beginning with this meeting, one of the key initiatives SCAI will focus on this year is workplace safety. There is a growing body of data that sheds light on the serious occupational risks that cath lab teams face over the course of their careers. In the last 18 months, there has been a significant increase in the data that has been published and new findings such as increased risk of premature vascular aging and cognitive impairment have shed light on the scope of the problem.