The transradial learning curve and volume-outcome relationship

This article discusses how learning curves correlate with learning in transradial catheterization. Although learning curves exist in the conversion to transradial approaches, current percutaneous coronary intervention (PCI) procedures are so safe that only surrogate end points such as contrast usage and x-ray exposure show learning effects. Using these surrogates, a learning curve of 30 to 50 patients seems typical to transition cardiologists from transfemoral to transradial PCI. This transition occurs with the immediate benefit of reduced vascular complications and bleeding and without loss of overall procedural success. These measures of safety during learning exist despite difference of procedural volumes.