title: Operator radiation exposure during percutaneous coronary procedures through the left or right radial approach: the TALENT dosimetric substudy.
abstract: BACKGROUND
  Transradial percutaneous coronary procedures may be effectively performed through the right radial approach (RRA) or the left radial approach (LRA), but data on radiation dose absorbed by operators comparing the two approaches are lacking. The aim of the present study was to evaluate radiation dose absorbed by operators during coronary procedures through the RRA and LRA.
  
  
  RESULTS
  Three operators were equipped with 5 different dosimeters (left wrist, shoulder, thorax outside the lead apron, thorax under the lead apron, and thyroid) during RRA or LRA for coronary procedures. Each month, the dosimeters were analyzed to determine the radiation dose absorbed. From February to December 2009, 390 patients were randomly assigned to the RRA (185 patients; age, 66±11 years) or the LRA (185 patients; age, 66±11 years). There were no significant differences in fluoroscopy time (for RRA, 369 seconds; interquartile range, 134 to 857 seconds; for LRA, 362 seconds; interquartile range, 142 to 885 seconds; P=0.58) between the 2 groups. There were no significant differences in monthly radiation dose at the thorax (0.85±0.46 mSv for RRA and 1.12±0.78 mSv for LRA, P=0.33), at the thyroid (0.36±0.2 mSv for RRA and 0.34±0.3 mSv for LRA, P=0.87), and at the shoulder (0.73±0.44 mSv for RRA and 0.94±0.42 mSv for LRA, P=0.27). The dose at the wrist was significantly higher for the RRA (2.44±1.12 mSv) compared with the LRA (1±0.8 mSv, P=0.002). In both radial approaches, the thoracic radiation dose under the lead apron was undetectable.
  
  
  CONCLUSIONS
  Compared with RRA, LRA for coronary procedures is associated with similar radiation dose for operators at the body, shoulder, or thyroid level, with a possible significant advantage at the wrist. The cumulative radiation dose for both approaches is well under to the annual dose-equivalent limit.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00282646.
authors.affiliation: Cardiology Department, Policlinico Casilino-ASL RM B, Rome, Italy. alessandro.sciahbasi@fastwebnet.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciahbasi
authors.forename: Enrico
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sarandrea
authors.forename: Francesco
authors.initials: F
authors.lastname: Summaria
authors.forename: Roberto
authors.initials: R
authors.lastname: Patrizi
authors.forename: Sunil
authors.initials: S
authors.lastname: Rao
authors.forename: Ernesto
authors.initials: E
authors.lastname: Lioy
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control*; D017534:Radial Artery / Q000601:surgery*; D011829:Radiation Dosage; D011835:Radiation Protection