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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
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Improving Patient Transfer in a Canadian Upper Extremity Revascularization Program
Virginie Arsenault1, Johnny I Efanov2, Frédéric Lavoie3
1From the Faculty of Medicine, University of Montréal.
Plastic and Reconstructive Surgery
|July 28, 2025
Summary
Implementing a dedicated transfer center significantly reduced avoidable patient transfers for upper extremity revascularization. This initiative improved communication and triage, optimizing the trauma network.
Area of Science:
- Trauma surgery
- Vascular surgery
- Healthcare management
Background:
- Centralization to trauma centers is standard for digital revascularization.
- Avoidable interhospital transfers challenge trauma networks.
- A dedicated 24/7 call center managed by specialized nurses was implemented.
Purpose of the Study:
- To investigate the impact of a dedicated transfer center on avoidable patient transfers for upper extremity revascularization.
- To assess changes in transfer outcomes after the center's implementation.
Main Methods:
- Retrospective study from September 2017 to December 2021.
- Analysis of 795 transfer requests for upper extremity revascularization.
- Comparison of outcomes before and after transfer center implementation in 2019 using univariate and multivariate analyses.
Main Results:
- Avoidable transfers decreased by 7.32% post-implementation (P = 0.047).
- Transfer refusals increased from 47% to 56% (P = 0.009), indicating improved triage.
- Communication between referring doctors and surgeons was enhanced.
Conclusions:
- Dedicated transfer centers reduce unnecessary interhospital transfers for digital revascularization.
- Improved triage selection and communication are key benefits of transfer centers.
- Transfer centers optimize trauma network efficiency.
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