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  • Title: Complication rate of venous access procedures performed by a radiology practitioner assistant compared with interventional radiology physicians and supervised trainees.
    Author: Benham JR, Culp WC, Wright LB, McCowan TC.
    Journal: J Vasc Interv Radiol; 2007 Aug; 18(8):1001-4. PubMed ID: 17675618.
    Abstract:
    PURPOSE: To compare venous access complication rates associated with procedures performed by radiology practitioner assistants (RPAs) versus interventional radiology (IR) faculty members, IR fellows, and radiology residents. MATERIALS AND METHODS: A retrospective review of venous access procedures in the IR department for 12 consecutive months at a single university hospital was performed. Procedural primary operators included 12 radiology residents, two IR fellows, four IR faculty members, and one board-certified RPA with 2 years of university training. Data examined included immediate and short-term complications separated into major and overall categories. RESULTS: A total of 2093 venous access procedures were performed. The RPA performed 670 procedures (temporary central venous catheter placement, n = 274; peripherally inserted central catheter, n = 67; venous access catheter change, n = 99; venous port placement, n = 126; tunneled central venous catheter placement, n = 39; catheter check, n = 32; and venous explant, n = 43). Similar procedure ratios were noted with faculty members, fellows, and residents. Procedures by the RPA had a major complication rate of 0.29% and an overall complication rate of 0.89%. Four IR faculty members performed 291 procedures, with no major complications and an overall complication rate of 1.71%. Two IR fellows performed 562 procedures, with a major complication rate of 0.35% and an overall complication rate of 1.06%. Twelve residents performed 570 procedures, with a major complication rate of 0.52% (range, 0%-2.46%) and an overall complication rate of 1.39% (range, 0%-3.70%). No significant difference was found among groups (P = .7). CONCLUSION: A properly trained and monitored RPA can safely perform selected venous access procedures with complication rates equal to those of IR faculty members, fellows, and residents.
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