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

Marlies M. Kok, Marieke G.M. Weernink, Clemens von Birgelen*, Anneloes Fens, Liefke C. van der Heijden, Janine A. van Til

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

43 Citations (Scopus)
77 Downloads (Pure)

Abstract

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<0.001). Most patients (38.0%) appreciated SDM, balanced between patient and cardiologist. Conclusions: Patients appreciate lower bleeding risk and early ambulation, factors favoring TRA. Previous experience with a single access route has a major impact on preference, while experience with both routes generally resulted in preference for TRA. Most patients prefer balanced SDM.

Original languageEnglish
Pages (from-to)17-24
Number of pages8
JournalCatheterization and cardiovascular interventions
Volume91
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Catheterization
  • Medical decision making
  • Patient preference
  • Transfemoral access
  • Transradial access

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