Operator exposure to x-ray in left and right radial access during percutaneous coronary procedures: OPERA randomised study.
OBJECTIVE
Left radial access (LRA) and right radial access (RRA) have been shown to be safe and effective for coronary arteries catheterisation. However, the differences between the two approaches in terms of radiation exposure are still unclear. The aim of the present investigation is to evaluate in a randomised study, the dose of radiation absorbed by operators using either LRA or RRA.


METHODS
Randomised, prospective, double arm, single centre study.


METHODS
University Hospital.


METHODS
Male or female subjects with stable, unstable angina and silent ischaemia.


METHODS
The present study is a comparison of LRA and RRA for coronary artery catheterisation in terms of operators' radiation exposure.


METHODS
The primary outcome measure was the radiation dose absorbed by operators; secondary outcome measures were fluoroscopy time, dose-area product and contrast delivered.


RESULTS
A total of 413 patients were enrolled; 209 were randomly selected to undergo diagnostic procedures with RRA and 204 with LRA. The operator's radiation exposure was significantly lower in the left radial group (LRA 33±37 μSv vs RRA 44±32 μSv, p=0.04). No significant differences were observed in  fluoroscopy time (LRA 349±231s vs RRA 370±246 s p=0.09) and dose-area product (LRA 7011.42±3617.30 μGym(2) vs RRA 7382.38±5226.61 μGym(2), p=0.80), even though in both there was a trend towards a lower level in the LRA. No differences were observed in contrast medium delivered (LRA 89.92±32.55 ml vs RRA 88.88±35.35 ml, p=0.45).


CONCLUSIONS
The LRA was associated in the present report with a lower radiation dose absorbed by the operator during coronary angiography.
Division of Cardiology, Department of Interventional Cardiology, Santa Maria University Hospital, Terni, Italy.
Marcello
M
Dominici
Roberto
R
Diletti
Caterina
C
Milici
Carlo
C
Bock
Attilio
A
Placanica
Gianluigi
G
D'Alessandro
Alessio
A
Arrivi
Marco
M
Italiani
Eduardo
E
Buono
Enrico
E
Boschetti
D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000000981:diagnostic imaging / Q000628:therapy; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000628:therapy; D006328:Cardiac Catheterization / Q000295:instrumentation; D062906:Cardiac Catheters; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006785:Hospitals, University; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000628:therapy*; D016273:Occupational Exposure; D016272:Occupational Health; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D015641:Radiography, Interventional; D013819:Thermoluminescent Dosimetry
D003287:Contrast Media