Interdepartmental cooperation in access-site management - verifiable persistent benefit for patients.

Background

Vascular access-site complications after catheterization remain a significant cause of morbidity and mortality. While patient- and procedure-related risk factors are well described, the impact of structured, interdisciplinary training programs is less well established. We evaluated the effect of a structured training program for cardiologists and interventional staff on access-site-related complications after transfemoral coronary interventions. Patients and methods: Over 36 months, we tracked all elective transfemoral coronary interventions at our institution. After an initial 6-month observational phase, we implemented a structured training program for cardiologists and catheter lab staff, using initial complication rates as the baseline. The training included quarterly sessions, pre-interventional angiological assessment for high-risk patients, pre-interventional assessment for all patients, and sheath removal by assistants. We prospectively assessed all access-site related complications using a standardized protocol and analysed incidence changes with a regression model, adjusting for patient-specific risk factors over time.

Results

Quarterly training and pre-interventional angiological assessment for high-risk patients did not significantly impact complication rates. However, pre-interventional angiographical assessment for all patients and sheath removal training for assistants significantly reduced complication rates. The results remained consistent after adjusting for patient-specific risk factors.

Conclusions

Structured angiological training for interventional staff significantly reduces access-site related complications. Interdisciplinary collaboration enhances patient safety and minimizes adverse events.