Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access.
The aim of this study was to evaluate radiation dose and patient discomfort/pain in radial artery access vs femoral artery access in percutaneous coronary intervention (PCI). Dose-area product (DAP) was measured non-randomised for 114 procedures using femoral access and for 55 using radial access. The patients also responded to a questionnaire concerning discomfort and pain during and after the procedure. The mean DAP was 69.8 Gy cm(2) using femoral access and 70.5 Gy cm(2) using radial access. Separating the access site from confounding factors with a multiple regression, there was a 13% reduction in DAP when using radial access (p=0.038). Procedure times did not differ (p=0.81). Bed confinement was much longer in the femoral access group (448 vs 76 min, p=0.000). With femoral access, there was a significantly higher patient grading for chest (p=0.001) and back pain (p=0.003) during the procedure and for access site (p=0.000) and back pain (p=0.000) after the procedure. Thirty-two femoral access patients (28%) were given morphine-type analgesics in the post-procedure period compared to three radial access patients (5%, p=0.001). DAP does not increase when using radial instead of femoral access and the patients grade discomfort and pain much lower when using radial access. Radial access is thus beneficial to use.
Geijer
Håkan
H
Department of Radiology, Orebro University Hospital, 701 85 Orebro, Sweden. hakan.geijer@orebroll.se
Persliden
Jan
J
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000628:therapy*; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001416:Back Pain / Q000209:etiology*; D002637:Chest Pain / Q000209:etiology*; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011677:Punctures; D017534:Radial Artery; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods*