Radiation Exposures Associated With Radial and Femoral Coronary Interventions

Overview

Journal Curr Treat Options Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2016 Oct 26

PMID 27778258

Citations 1

Authors

Konstantinos V Voudris

Martha Habibi

Panagiotis Karyofillis

Mladen I Vidovich

Affiliations

Soon will be listed here.

Abstract

The volume of cardiac diagnostic procedures involving the use of ionizing radiation has increased rapidly in recent years, and the radiation exposure experienced by patients undergoing any medical imaging procedure has recently obtained a growing attention. Transradial (TR) access is being increasingly used worldwide for diagnostic coronary angiography (CA), and percutaneous coronary interventions, since it offers several benefits as compared to transfemoral (TF) access, such as by reducing hemostasis time and vascular complications, increased patient comfort, reduced hospital stay, and lower cost. In contrast, TR CA is thought to be associated with increased radiation exposure parameters compared with the traditional TF access. Although experienced operators may almost counterbalance this shortcoming, the increase in radiation exposure associated with TR approach seems not to be present in most clinical settings.

Citing Articles

Radiation protection in the cardiac catheterization laboratory.

Biso S, Vidovich M J Thorac Dis. 2020; 12(4):1648-1655.

PMID: 32395308 PMC: 7212171. DOI: 10.21037/jtd.2019.12.86.

References

Johnson L, Moore R, Balter S . Review of radiation safety in the cardiac catheterization laboratory. Cathet Cardiovasc Diagn. 1992; 25(3):186-94. DOI: 10.1002/ccd.1810250304. View

Jolly S, Yusuf S, Cairns J, Niemela K, Xavier D, Widimsky P . Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011; 377(9775):1409-20. DOI: 10.1016/S0140-6736(11)60404-2. View

Lo T, Ratib K, Chong A, Bhatia G, Gunning M, Nolan J . Impact of access site selection and operator expertise on radiation exposure; a controlled prospective study. Am Heart J. 2012; 164(4):455-61. DOI: 10.1016/j.ahj.2012.06.011. View

Mercuri M, Xie C, Levy M, Valettas N, Natarajan M . Predictors of increased radiation dose during percutaneous coronary intervention. Am J Cardiol. 2009; 104(9):1241-4. DOI: 10.1016/j.amjcard.2009.06.037. View

Sciahbasi A, Romagnoli E, Burzotta F, Trani C, Sarandrea A, Summaria F . Transradial approach (left vs right) and procedural times during percutaneous coronary procedures: TALENT study. Am Heart J. 2010; 161(1):172-9. DOI: 10.1016/j.ahj.2010.10.003. View

Caputo R, Tremmel J, Rao S, Gilchrist I, Pyne C, Pancholy S . Transradial arterial access for coronary and peripheral procedures: executive summary by the Transradial Committee of the SCAI. Catheter Cardiovasc Interv. 2011; 78(6):823-39. DOI: 10.1002/ccd.23052. View

Porto I, Bolognese L, Dudek D, Goldstein P, Hamm C, Tanguay J . Impact of Access Site on Bleeding and Ischemic Events in Patients With Non-ST-Segment Elevation Myocardial Infarction Treated With Prasugrel: The ACCOAST Access Substudy. JACC Cardiovasc Interv. 2016; 9(9):897-907. DOI: 10.1016/j.jcin.2016.01.041. View

Sciahbasi A, Calabro P, Sarandrea A, Rigattieri S, Tomassini F, Sardella G . Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic.... Cardiovasc Revasc Med. 2014; 15(4):209-13. DOI: 10.1016/j.carrev.2014.03.010. View

Shah R, Patel D, Abbate A, Cowley M, Jovin I . Comparison of transradial coronary procedures via right radial versus left radial artery approach: A meta-analysis. Catheter Cardiovasc Interv. 2016; 88(7):1027-1033. DOI: 10.1002/ccd.26519. View

10.

Christopoulos G, Makke L, Christakopoulos G, Kotsia A, Rangan B, Roesle M . Optimizing Radiation Safety in the Cardiac Catheterization Laboratory: A Practical Approach. Catheter Cardiovasc Interv. 2015; 87(2):291-301. DOI: 10.1002/ccd.25959. View

11.

Feldman D, Swaminathan R, Kaltenbach L, Baklanov D, Kim L, Wong S . Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007-2012). Circulation. 2013; 127(23):2295-306. DOI: 10.1161/CIRCULATIONAHA.112.000536. View

12.

Neill J, Douglas H, Richardson G, Chew E, Walsh S, Hanratty C . Comparison of radiation dose and the effect of operator experience in femoral and radial arterial access for coronary procedures. Am J Cardiol. 2010; 106(7):936-40. DOI: 10.1016/j.amjcard.2010.06.002. View

13.

Park E, Shroff A, Crisco L, Vidovich M . A review of radiation exposures associated with radial cardiac catheterisation. EuroIntervention. 2013; 9(6):745-53. DOI: 10.4244/EIJV9I6A119. View

14.

Brasselet C, Blanpain T, Tassan-Mangina S, Deschildre A, Duval S, Vitry F . 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 Heart J. 2007; 29(1):63-70. DOI: 10.1093/eurheartj/ehm508. View

15.

Kiemeneij F, Laarman G, Odekerken D, Slagboom T, van der Wieken R . A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. J Am Coll Cardiol. 1997; 29(6):1269-75. DOI: 10.1016/s0735-1097(97)00064-8. View

16.

Eisenberg M, Afilalo J, Lawler P, Abrahamowicz M, Richard H, Pilote L . Cancer risk related to low-dose ionizing radiation from cardiac imaging in patients after acute myocardial infarction. CMAJ. 2011; 183(4):430-6. PMC: 3050947. DOI: 10.1503/cmaj.100463. View

17.

Jolly S, Cairns J, Niemela K, Steg P, Natarajan M, Cheema A . Effect of radial versus femoral access on radiation dose and the importance of procedural volume: a substudy of the multicenter randomized RIVAL trial. JACC Cardiovasc Interv. 2013; 6(3):258-66. DOI: 10.1016/j.jcin.2012.10.016. View

18.

Bertrand O, Rao S, Pancholy S, Jolly S, Rodes-Cabau J, Larose E . Transradial approach for coronary angiography and interventions: results of the first international transradial practice survey. JACC Cardiovasc Interv. 2010; 3(10):1022-31. DOI: 10.1016/j.jcin.2010.07.013. View

19.

Brueck M, Bandorski D, Kramer W, Wieczorek M, Holtgen R, Tillmanns H . A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty. JACC Cardiovasc Interv. 2009; 2(11):1047-54. DOI: 10.1016/j.jcin.2009.07.016. View

20.

Dominici M, Diletti R, Milici C, Bock C, Garg S, De Paolis M . Left radial versus right radial approach for coronary artery catheterization: a prospective comparison. J Interv Cardiol. 2012; 25(2):203-9. DOI: 10.1111/j.1540-8183.2011.00689.x. View