Document Detail


Comparison of radiation dose and the effect of operator experience in femoral and radial arterial access for coronary procedures.
MedLine Citation:
PMID:  20854953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Radial access coronary procedures are associated with fewer access site complications compared to femoral access. There is controversy regarding greater radiation exposure to patient and operator using radial access. We aimed to compare radiation dose during coronary procedures for the 2 access routes and assess the effect of operator experience with radial access on radiation dose. Fluoroscopy time (FT) and dose-area product (DAP) were recorded for all radial access and femoral access procedures during default femoral access, transition phase (femoral access and early radial access), and default radial access. Femoral access cases (n = 848, 412 diagnostic, 436 percutaneous coronary interventions [PCIs]) and radial access cases (n = 965, 459 diagnostic, 506 PCIs) were assessed. For diagnostics, median FT for radial access was longer than for femoral access (4.43 minutes, interquartile range [IQR] 2.55 to 8.18, vs 2.34 minutes, IQR 1.49 to 4.18, p <0.001) and associated with larger DAP (radial access 1,837 μGy·m(2), IQR 1,172 to 2,783, vs femoral access 1,657 μGy·m(2), IQR 1,064 to 2,376, p <0.001). For PCI, FT was longer for radial access (median 12.02 minutes, IQR 7.57 to 17.54, vs femoral access 9.36 minutes, IQR 6.13 to 14.27, p <0.001)-this did not translate into an increased DAP (femoral access median 3,392 μGy·m(2), IQR 2,139 to 5,193, vs radial access 3,682 μGy·m(2), IQR 2,388 to 5,314, p = NS). For diagnostic radial access, FT decreased from the transition phase (n = 134) to the default radial access phase (n = 323, 5.12 minutes, IQR 3.07 to 9.40, vs 4.21 minutes, IQR 2.49 to 7.52, p = 0.03). This was not observed for PCI. In conclusion, transition from femoral access to radial access for diagnostics and PCI increased FT. DAP increased for diagnostic radial access but not PCI compared with femoral access. FTs for radial access diagnostic cases decreased with experience.
Authors:
Johanne Neill; Hannah Douglas; Geoffrey Richardson; Eng-Wooi Chew; Simon Walsh; Colm Hanratty; Niall Herity
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-08-11
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-21     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  936-40     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Belfast City Hospital, Cardiology Centre, Belfast, Northern Ireland, United Kingdom. johanneneill@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Female
Femoral Artery
Fluoroscopy
Humans
Male
Radial Artery
Radiation Dosage

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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