IS Trans-Radial Approach Related to an Increased RisK of RAdiation Exposure In Patients Who Underwent Diagnostic CoronaRY Angiography or Percutaneous Coronary Intervention? (The SAKARYA Study)

Üreyen, Çağın Mustafa; Coşansu, Kahraman; Vural, Mutlu; Şahin, Sait Emir; Kocayiğit, İbrahim; Pabuccu, Mustafa Türker; Aksoy, Muhammed Necati Murat; Ağaç, Mustafa Tarık; Tatlı, Ersan; Gündüz, Hüseyin; Akdemir, Ramazan

doi:10.14744/anatoljcardiol.2019.06013

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…Although, there was no significant difference between groups regarding thrombus aspiration and tirofiban infusion but CS patients had highly significant more complex coronary artery disease in the form of multivessel, left main coronary artery affection and consequently significant higher number of intracoronary stents displacement in present study. Comparable findings were revealed by a study concluding percutaneous coronary interventions through radial route are significantly associated to radiation exposure but diagnostic coronary angiography using radial access was not associated with higher exposure to radiation [ 24 ]. Contrary findings were reported by another recent study which reported significantly lower fluoroscopic time and lesser contrast volume in trans-femoral route [ 25 ].…”

Section: Discussionmentioning

confidence: 93%

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Shalaby¹,

Niazi²,

Khaled³

2023

Journal of the Saudi Heart Association

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Background Cardiogenic Shock (CS) remains the most common cause of death in hospitalized acute ST-segment elevation myocardial infarction (STEMI) patients. Predictors of outcomes in those patients include clinical, laboratory, radiologic variables, and management strategies. The present study aimed to evaluate the incidence, characteristics, predictors of cardiogenic shock and mortality among acute ST-segment elevation myocardial infarction patients in our center. Methods This was a retrospective, single-center study conducted at KAMC, Makkah during 2015–2020. All acute ST-segment elevation myocardial infarction patients during this era were divided into two groups CS group and non-CS group. Results In this study total 3074 acute ST-segment elevation myocardial infarction patients of which 132(4.3%) patients had CS. CS group tended to have higher ages than non-CS group. Pilgrims were more complicated by CS than nonpilgrims. Subsequently, CS patients had a highly significant (p < 0.001 for all) increase in the incidence of in-hospital complications including pulmonary oedema, cardiac arrest and ventilation. There was a significant increase in hospital stay length and in-hospital mortality among CS patients. Renal impairment, peak troponin level, haemoglobin drop≥3 gm/dl, and Left ventricular ejection fraction (EF) were significant independent predictors of cardiogenic shock among our patients. However, STEMI type, left main disease, and EF was the independent predictors of CS among our patients with diabetes with EF cut-off value of 35% with a sensitivity of 74.6% and a specificity of 65.3%. Age was the only independent predictor of mortality among CS patients. Though age, female gender, and diabetes were found to be the independent predictors for in-hospital mortality among our patients. Conclusion High-income middle eastern countries have comparable outcomes to Europe and USA among patients with acute ST-segment elevation myocardial infarction patients with higher improvement of medical care in the last 2 to 3 decades. Renal impairment, peak troponin, severe bleeding and ejection fraction were significant independent predictors of CS in acute ST-segment elevation myocardial infarction patients. However, STEMI type, left main disease, and ejection fraction were the independent predictors of CS in acute ST-segment elevation myocardial infarction patients with diabetes. Age was the only independent predictor of mortality among CS patients.

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Section: Discussionmentioning

confidence: 93%

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Shalaby¹,

Niazi²,

Khaled³

2023

Journal of the Saudi Heart Association

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Occupational and Patient Radiation Dose and Quality Implications of Femoral Access Imaging During Coronary Angiography

Wilson‐Stewart

Fontanarosa

Malacova

et al. 2021

JMDH

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Purpose: Cardiologists often perform angiography of the common femoral artery (CFA) access site to evaluate whether the anatomy is suitable for deployment of a vascular closure device or to assess whether iatrogenic vessel damage has occurred. The choice of acquisition mode has radiation dose implications. The objective of this study was to investigate the influence of the selected type of CFA x-ray imaging mode (fluoro save, cine acquisition and digital subtraction angiography (DSA)) and tube angle on patient and staff dose during coronary angiography. Materials and Methods: Assessment of image quality for the different modes was performed to determine whether lower dose modes provide images of sufficient clinical quality to be routinely employed. Radiation dose levels for the patients (n=782), cardiologists (n=17), scrub nurses (n=27) and scout nurses (n=32) were measured in a prospective singlecentre study between February 2017 and August 2019. Three Philips angiographic units and DoseAware dose monitoring systems were used. Results: Among the acquisition modes, fluoro save provided acceptable diagnostic quality for visualizing femoral access points and diagnosing pathology in 99% of cases. Average patient dose area product (DAP) was 83.95, 742.50, and 3363.41mGy 2 and average patient air kerma (AK) was 0.87, 8.44, and 18.61mGy for fluoro save, cine, and DSA acquisitions, respectively. The use of higher dose imaging modes, imaging in the contralateral view and utilizing steeper TA was associated with a higher patient dose. Due to staff dose being highly correlated with DAP and AK, it was difficult to observe any association between staff dose and CFA imaging mode. However, this does not discount a potential increase in occupational dose due to the use of cine angiography or digital subtraction angiography during CFA imaging. Conclusion: DSA of the CFA should be avoided during transfemoral coronary angiography unless critical to diagnostic analysis. It is recommended that fluoroscopic operators consider utilizing lower dose modes in the ipsilateral orientation ≤32° TA to reduce the risk of patient and staff radiation exposure.

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Comparison of Radiation Dose and Contrast Dye Volume Comparison in Coronary Angiography Via Femoral and Radial Routes

Ullah,

Arshad,

Ullah

et al. 2023

PJHS

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Coronary angiography is a common procedure used to identify coronary artery disease. Whether femoral or radial vascular access is employed may impact radiation dosage and contrast dye utilization. This study examined radiation exposure and contrast dye volume in femoral and radial approach in patients undergoing coronary angiography. Objective: To assess and compare the radiation dosage and contrast dye volume between patients having coronary angiography through the femoral and radial routes. Methods: A prospective study included 408 consecutive coronary angiography patients from April 10 to August 31, 2023. The remaining 206 patients were treated radially, while 202 were treated femorally. We examined radiation exposure, dose area product (DAP), and contrast dye volume among groups. Results: Radial and femoral groups had similar mean ages (64.4±12.1 vs. 64.8±11.6, p=0.86). The radial group had 60.67% men versus 71.3% in femoral group. Radial and femoral catheterization radiation doses were 1.199 Gy (0.677-2.001) and 1.218 Gy (0.696-2.207), respectively, with a p-value of 0.88 showing no group radiation exposure difference. The group analysis found no hemorrhagic consequences from radial or femoral catheterization, coronarography, or angioplasty. Conclusions: The study participants noticed non-significant differences in contrast dye volume and radiation dose between femoral and radial coronary angiography.

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IS Trans-Radial Approach Related to an Increased RisK of RAdiation Exposure In Patients Who Underwent Diagnostic CoronaRY Angiography or Percutaneous Coronary Intervention? (The SAKARYA Study)

Cited by 3 publications

References 25 publications

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Cardiogenic Shock Among Patients with Acute Myocardial Infarction in a middle eastern Country: A Single-centre experience

Occupational and Patient Radiation Dose and Quality Implications of Femoral Access Imaging During Coronary Angiography

Comparison of Radiation Dose and Contrast Dye Volume Comparison in Coronary Angiography Via Femoral and Radial Routes

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