Gaining a New Skill With the Risk of Losing One: The Effect of Radial Catheterization

The adoption of radial catheterization has been relatively slow in the United States. This study was conducted to assess the perceived comfort level of cardiology fellows with radial catheterizations and to predict the practice patterns in the United States in the near future. A 21-question survey on cardiology fellows' preferred cardiac catheterization access site was conducted between April and June 2015. Data on access preference and perceived competency were analyzed based on the fellow's level of training and type of training program (university vs community). A total of 101 responses were received from a total of 250 invitations; 85 (85%) of these respondents completed all questions. Data were collected from fellows of several programs nationwide. Of the 85 respondents with complete data, 22%, 29%, and 19% were first-, second-, and third-year interventional fellows respectively. Most respondents (82%) were from university-based programs, 46.3% of respondents considered that their programs provided a balance of both radial and femoral training. Irrespective of the training year, most fellows seemed to prefer radial over femoral access. Senior fellows appeared to be equally comfortable with a femoral access approach (P = 0.03). There was no difference by training site (university vs community programs) (P = 0.921). In 2015, US cardiology fellows appear to prefer radial over femoral access for cardiac catheterizations. Although it is good to see the shift toward better radial access skills, we need to stress the importance of the femoral skills that would be necessary to keep in the armamentarium of interventional cardiologists.