Patient preference for radial versus femoral vascular access for elective coronary procedures: The PREVAS study

• Published in: Catheterization and cardiovascular interventions 2018-01, Vol.91 (1), p.17-24
• Main Authors: Kok, Marlies M., Weernink, Marieke G.M., von Birgelen, Clemens, Fens, Anneloes, van der Heijden, Liefke C., van Til, Janine A.
• Format: Article
• Language: English
• Subjects: Access routes; Aged; Attitude of Health Personnel; Bleeding; Cardiac Catheterization - adverse effects; Cardiac Catheterization - methods; Cardiologists - psychology; Catheterization; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - methods; Catheters; Choice Behavior; Clinical Decision-Making; Clinical trials; Coronary Artery Disease; Decision making; Early Ambulation; Female; Femoral Artery; Femur; Health Knowledge, Attitudes, Practice; Hemorrhage - etiology; Humans; Length of Stay; Male; medical decision making; Middle Aged; Patient Participation; Patient Preference; Patients; Punctures; Radial Artery; Risk factors; Scaling; Surveys and Questionnaires; transfemoral access; transradial access; Venous access
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.27039

Objectives To explore patient preference for vascular access site in percutaneous coronary procedures, the perceived importance of benefits and risks of transradial access (TRA) and transfemoral access (TFA) were assessed. In addition, direct preference for vascular access and preference for shared decision making (SDM) were evaluated. Background TRA has gained significant ground on TFA during the last decades. Surveys on patient preference have mostly been performed in dedicated TRA trials. Methods In the PREVAS study (Clinicaltrials.gov: NCT02625493) a stated preference elicitation method best‐worst scaling (BWS) was used to determine patient preference for six treatment attributes: bleeding, switch of access‐site, postprocedural vessel quality, mobilization and comfort, and over‐night stay. Based on software‐generated treatment scenarios, 142 patients indicated which characteristics they perceived most and least important in treatment choice. Best‐minus‐Worst scores and attribute importance were calculated. Results Bleeding risk was considered most important (attribute importance 31.3%), followed by length of hospitalization (22.6%), and mobilization(20.2%). Most patients preferred the approach of their current procedure (85.9%); however, 71.1% of patients with experience with both access routes favored TRA (P