Cor Vasa 2011, 53(6-7):318-321 | DOI: 10.33678/cor.2011.080

Radiation exposure of operator during coronary angiography and coronary intervention: comparison of left radial and femoral accesses

Roman Štípal1,*, Jiří Ostřanský1, David Richter1, Martin Sluka1, Marcela Škvařilová1, Martin Zaoral2, Miloš Táborský1
1 I. interní klinika - kardiologická, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého, Olomouc
2 Oddělení lékařské fyziky a radiační ochrany, Fakultní nemocnice a Lékařská fakulta Univerzity Palackého, Olomouc, Česká republika

Aim: To compare the radiation dose equivalent during selective coronary angiography (SCA) and SCA followed by percutaneous coronary intervention (PCI) by left radial (LRA) and femoral (FA) accesses.

Methods: 380 consecutive patients, 66.6 ± 10.5 years old, 68.9% of men, BMI 29.4 ± 5.0, were examined. By LRA 70.2% (50% SCA and 20.2% PCI), by FA 29.8% (14% SCA and 15.8% PCI) procedures were performed. During each procedure, LRA vs. FA comparisons of radiation time and radiation dose were registered.

Results: There was no diference in selective coronary angiography group between LRA vs. FA concerning gender, age, BMI and radiation time. Radiation dose in LRA vs. FA was 3.31 ± 5.52 vs. 1.23 ± 2.77 μSv, median 2.0 vs. 0.0 μSv (p < 0.0001). There was no diference in percutaneous coronary intervention group between LRA vs. FA concerning gender and age. By LRA vs. FA, BMI was higher 30.4 ± 4.7 vs. 28.4 ± 5.3 (p = 0.0003), radiation time was longer 13.13 ± 9.34 vs. 9.50 ± 7.23 min, median 10.20 vs. 6.85 min (p = 0.001), and radiation dose was higher 11.61 ± 25.74 vs. 3.10 ± 4.38 μSv, median 5.0 vs. 1.5 μSv (p < 0.0001).

Conclusions: During SCA, despite the same radiation time, the radiation dose was higher by LRA vs. FA. During PCI, the radiation dose by LRA vs. FA was also higher but the patients had higher BMI and longer radiation time. Authors conclude that the main problem is radiation protection by LRA.

Keywords: Dose equivalent; Selective coronary angiography; Percutaneous coronary intervention; Radial access

Published: June 1, 2011  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Štípal R, Ostřanský J, Richter D, Sluka M, Škvařilová M, Zaoral M, Táborský M. Radiation exposure of operator during coronary angiography and coronary intervention: comparison of left radial and femoral accesses. Cor Vasa. 2011;53(6-7):318-321. doi: 10.33678/cor.2011.080.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Branny M, Indrák J, Černý J, et al. Radiální přístup pro koronární angiografii a perkutánní koronární intervenci. Interv Akut Kardiol 2008;7:60-64.
    2. Bernat I, Rokyta R, Koza J, et al. Radiální přístup u koronárních a nekoronárních katetrizací a intervencí. Cor Vasa 2009;Suppl 1.
    3. Schaufele TG, Grunebaum JP, Lippe B, et al. Radial access versus conventional femoral puncture: Outcome and resource effectiveness in daily routine. The RAPTOR trial. Orlando: AHA, 2009.
    4. Saumanaki KI. Radiation Protection in the Cardiac Catheterization Laboratory. Interv Cardiol 2010;2:667-672. Go to original source...
    5. Martinez CA, Cohen MG. Left or Right, Transradial Access for All. J Invas Cardiol 2010;22:398-399.
    6. Sciahbasi A. Transradial approach (left vs. right) and procedural times during percutaneous coronary procedures: TALENT study. EuroPCR 2010. Go to original source...
    7. Agostini P, Biondi-Zoccai GGL, De Benedictis ML, et al. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures. J Am Coll Cardiol 2004;44:349-356. Go to original source... Go to PubMed...
    8. Štípal R, Richter D, Sluka M, et al. Transradiální přístup zleva jako standard při koronární diagnostice a intervenci. Abstrakta XIX. výročního sjezdu ČKS, www.cksonline.cz
    9. Guédes A, Dangoisse V, Gabriel L, et al. Low rate of conversion to transfemoral approach when attempting both radial arteries for coronary angiography and percutaneous coronary intervention: a study of 1,826 consecutive procedures. J Invasive Cardiol 2010;22:398-399. Go to PubMed...
    10. Jolly SS, Amlani S, Hamon M, et al. Radial verus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: A systemic review and meta-analysis of randomized trials. Am Heart J 2009;157:132-140. Go to original source... Go to PubMed...
    11. Komócsi A, Aradi D. Transradial Coronary Intervention. Radiant or Brilliant? J Am Coll Cardiol 2010;56:1265-1266. Go to original source... Go to PubMed...
    12. Vorobcsuk A, Kónyi A, Aradi D, et al. Transradial versus transfemoral percutaneous coronary intervention in acute myocardial infarction. Systematic overview and meta-analysis. Am Heart J 2009;158:814-821. Go to original source... Go to PubMed...
    13. Chase AJ, Fretz EB, Warbuton WP, et al. Association of the arterial access site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg). Heart 2008;94:1530-1532. Go to original source... Go to PubMed...
    14. Kanei Y, Nakra NC, Liou M. Randomized Comparison of Transradial Coronary Angiography Via Right or Left Radial Artery Approaches. Am J Cardiol 2011;107:195-197. Go to original source... Go to PubMed...
    15. Santas E, Bodí V, Sanchis J, et al. The Left Radial Approach in Daily Practice. A Randomized Study Comparing Femoral and Right and Left Radial Approaches. Rev Esp Cardiol 2009;62:482-490. Go to original source... Go to PubMed...
    16. Cha KS, Kim MH, Kim HJ. Prevalence and clinical predictors of severe tortuosity of right subclavian artery in patients undergoing transradial coronary angiography. Am J Cardiol 2003;92:1220-1222. Go to original source... Go to PubMed...
    17. Kawashima O, Endoh N, Terashima M, et al. Effectiveness of right or left radial approach for coronary angiography. Catheter Cardiovasc Interv 2004;61:333-337. Go to original source... Go to PubMed...
    18. Hamon M. Radiation exposure and vascular access site. Eur Heart J 2008;29:954. Go to original source... Go to PubMed...
    19. Pristipino Ch. Radial artery catheterization and radiological exposure. Eur Hear J 2008;29:2316-2317. Go to original source... Go to PubMed...
    20. Brueck M, Bandorski D, Kramer W, et al. A Randomized Comparison of Transradial Versus Transfemoral Approach for Coronary Angiography and Angioplasty. J Am Coll Cardiol Intv 2009;2:1047-1054. Go to original source... Go to PubMed...
    21. Lange HW, Boetticher H. Randomized comparison of operator radiation exposure dutiny coronary angiography and intervention by radial or femoral approach. Catheter Cardiovasc Interv 2006;67:12-16. Go to original source... Go to PubMed...
    22. Brasselet C, Blanpain T, Tassan-Mangina S, et al. Comparison of operator radiation exposure with optimized radiation protection devices during coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes. Eur Hear J 2008;29:63-70. Go to original source... Go to PubMed...
    23. Lo TS, Zaman AG, Stables R, et al. Comparison of operator radiation exposure with optimized radiation protection devices during coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes. Comment. Eur Heart J 2008;29:2180. Go to original source...
    24. Agostoni P. Comment on "Comparison of operatos radiation exposure with optimized radiation protection device dutiny coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes". Eur Heart J 2008;29:2820-2821. Go to original source... Go to PubMed...
    25. Rao SV, Cohen MG, Kandzari DE, et al. The Transradial Approach to Percutaneous Coronary Intervention. J Am Coll Cardiol 2010;55:2187-2195. Go to original source... Go to PubMed...
    26. Efstathopoulus EP, Makrygiannis SS, Kottou S, et al. Medical personnel and patient dosimetry during coronary angiography and intervention. Phys Med Biol 2003;48:3059. Go to original source... Go to PubMed...
    27. Bertrand OF, Arsenault J, Mongrain R. Operator vs. patient radiation exposure in transradial and transfemoral coronary interventions. Eur Hear J 2009;29:2577-2578. Go to original source... Go to PubMed...

    Return to the content


    Cor et Vasa

    You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

    I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.


    No
    Yes