Evaluation of patient-absorbed doses during coronary angiography and intervention by femoral and radial artery access.
The aim of this study was to compare the radiation dose to patients during coronary angiography (CA) and coronary intervention (percutaneous transluminal coronary angioplasty, PTCA) by the femoral or radial artery access routes. A plane-parallel ionisation chamber, mounted on an under-couch X-ray tube (Siemens Coroskop TOP with an optional dose reduction system), recorded the dose-area product (DAP) to the patient from 40 coronary angiographies and 42 coronary interventions by the femoral route. The corresponding numbers for radial access were 36 and 24, respectively. Using a human-shaped phantom, conversion factors between maximum entrance surface dose and DAP were derived for CA and CA plus PTCA, respectively. The dose to the staff was measured with TL dosimeters for 22 examinations. Fluoroscopy time and DAP were significantly (p=0.003) larger using the radial access route for coronary angiography (7.5 min, 51 Gy cm2) than the corresponding values obtained from femoral access route (4.6 min, 38 Gy cm2). For CA plus PTCA the fluoroscopy time and DAP were larger for radial access (18.4 min, 75 Gy cm2) than for femoral access (12.5 min, 47 Gy cm2; p=0.013). In our experience, radial access did significantly prolong the fluoroscopy time and increase the patient doses.
Sandborg
Michael
M
Department of Radiation Physics, Faculty of Health Sciences and University Hospital, 58185 Linköping, Sweden. michael.sandborg@imv.liu.se
Fransson
Sven-Göran
SG
Pettersson
Håkan
H
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005263:Femoral Artery; D005471:Fluoroscopy; D006801:Humans; D008875:Middle Aged; D017534:Radial Artery; D011829:Radiation Dosage; D011835:Radiation Protection; D015641:Radiography, Interventional; D013997:Time Factors