Radiation Exposure with the Radial Approach for Diagnostic Coronary Angiography in a Centre Previously Performing Purely the Femoral Approach

Abstract

The radial approach was associated with significantly higher DAP and FT compared to the femoral approach during an initial introductory phase which was likely insufficient to develop radial proficiency. The results of this study are consistent with previous studies and may influence choice of access for non-emergent diagnostic coronary angiography before radial proficiency has been established, particularly for patients more susceptible to radiation risks.

Predictors of prolonged fluoroscopy time in diagnostic coronary angiography

“…As was the same with several previous studies, prolonged fluoroscopy time had no significant relationship with operator's experience [10] or catheter size [11,12]. Although there were several studies which suggest that the fluoroscopy time in coronary angiography or percutaneous coronary intervention was significantly greater in radial approach than femoral approach [13][14][15][16][17][18] or greater in right radial approach than in left radial approach [19][20][21][22][23], there was no significant association with approach sites in the present study. In our institution, right radial approach is the first choice for coronary angiography (83.4% of all procedures) even for junior operators, therefore, we might be accustomed to perform coronary angiography via right radial approach.…”

Comparison of the patient radiation exposure during coronary angiography and angioplasty procedures using trans-radial and trans-femoral access

“…The results of the present study did not show significant differences in the mean patients’ DAP between the two access techniques in the CA procedure (P>0.05), which is in agreement with the results of some similar studies 20 , 21 and different from those of some others. 16 , 18 Since there is a linear relationship between BMI and DAP, 32 the differences between the results might dueto the patients higher BMI in the TRA group in comparison with TFA in the study by Neill et al 32 In this study there was no significant differences in BMI in two access group with P > 0.05.…”

“…In addition, a higher radiation dose that found in a study by Vlachadis et al with the radial access might be related to the operators’ lower experience, because the femoral access was routine technique of angiography in the centre that study was conducted. 16 …”

“… 8 , 9 The results of clinical studies have shown that trans-radial access (TRA) is superior to trans-femoral access (TFA) due to a reduction in mortality in patients undergoing Primary PCI for STEMI, 10 , 11 decreased access site complications, 9 , 10 , 12 high safety and efficacy, a decrease in the duration of hospitalization, rapid recovery and return to daily routines, and a decrease in costs. 13 - 15 Some of studies indicated higher patient radiation dose associated by TRA 16 - 18 and some other related to the lower and equal patient dose, 19 - 21 therefore there is controversy over the amount of radiation dose that received by the patient in the TRA in comparison with the TFA and there is no consensus over it. 16 , 22 On the other hand, many of studies in this respect have not been appropriate and comprehensive and have only evaluated the absorbed radiation dose as a secondary aim of the study along with clinical evaluations.…”

“… 13 - 15 Some of studies indicated higher patient radiation dose associated by TRA 16 - 18 and some other related to the lower and equal patient dose, 19 - 21 therefore there is controversy over the amount of radiation dose that received by the patient in the TRA in comparison with the TFA and there is no consensus over it. 16 , 22 On the other hand, many of studies in this respect have not been appropriate and comprehensive and have only evaluated the absorbed radiation dose as a secondary aim of the study along with clinical evaluations.…”