Advice for Fellows from Dr. Zaher Hakim

August 27, 2019

Balancing Radial and Femoral Large Bore Access Cases

Dr. Zaher Hakim speaks with Dr. Chadi Alraies, offering advice for fellows. Dr. Hakim is an interventional cardiology fellow at Wayne State University/Detroit Medical Center.

Dr. Hakim acknowledges that during the first few months every fellow faces challenges, one of which is getting familiar with the cath lab and staff. He speaks about the importance of getting to know the nurses, the techs, and the attendings. “You need time to get comfortable with each attending and the attendings to get comfortable with you.” Dr. Hakim emphasizes the importance of carefully preparing each patient and discussing the patient and plan with the attending. “Get permission for every step from the attending so he gets comfortable with you and he trusts you.”

Dr. Hakim mentions that today a lot of centers primarily use the radial approach and, as a result, many fellows are not gaining skills and adequate comfort level with large bore femoral access techniques. His advice to fellows is to seek a balanced program and balanced case volume: “ideally 50% radial cases, 50% femoral large bore access cases.” He also emphasizes the importance of being familiar with and comfortable with all closure devices, explaining that each closure device has its pros and cons for use in different situations and it is important to get as much experience as possible with all of them.

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