Operator exposure to x-ray in left and right radial access during percutaneous coronary procedures: OPERA randomised study

Abstract

The LRA was associated in the present report with a lower radiation dose absorbed by the operator during coronary angiography.

Patient radiation exposure in right versus left trans-radial approach for coronary procedures

“…Indeed, in the TALENT study, LR was associated with a significantly lower amount of fluoroscopy and DAP as compared to RR in the fellow group, whereas no differences were observed in the senior operator group [14]. Nevertheless, in the OPERA randomized study no significant differences were observed in DAP, fluoroscopy time and contrast volume despite 3 out of 5 operators were not expert in trans-radial approach (less than 100 procedures performed by each operator) [17]. Catheter shapes appositely designed for trans-radial approach are commercially available and were shown to be associated with lower procedural time when used by RR as compared to LR [18].…”

Operator radiation exposure during right or left transradial coronary angiography: A phantom study

“…Three previous clinical and randomized studies [9,12,13] showed a lower radiation dose absorbed by operators during LRA compared to RRA for percutaneous coronary procedures. A possible explanation of these results was attributed to the lower fluoroscopy times during LRA.…”

“…However the left radial access (LRA) has some important advantages in terms of reduced learning curve for fellows [9] reduced rate of vessel tortuosity [9,10], and higher catheter back up during percutaneous coronary interventions Cardiovascular Revascularization Medicine xxx (2015) xxx-xxx [11] even if it is less comfortable for operators [12]. Moreover recently three different randomized studies [9,12,13] showed an unexpected possible advantage of LRA in terms of radiation dose absorbed by operators compared to RRA. A possible explanation of this advantage has been attributed to the lower (even not significant) fluoroscopy times during LRA compared to RRA but this issue is not clarified.…”

Left Radial Access Is Preferable to Right Radial Access for the Diagnostic or Interventional Coronary Procedures: A Meta-Analysis Involving 22 Randomized Clinical Trials and 10287 Patients

“…The transradial approach has been used extensively for both diagnostic and interventional coronary procedures; however, there is no universal consensus hitherto on the optimal choice of radial access from either the left or the right artery [1]–[3]. Currently, this choice is largely dependent on the operator’s preference.…”