title: 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 implementation of angioX - RAdiation Dose study (RAD-MATRIX).
abstract: BACKGROUND
  Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access.
  
  
  METHODS
  The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access.
  
  
  CONCLUSIONS
  The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes.
authors.affiliation: Interventional Cardiology, Sandro Pertini Hospital - ASL RMB, Rome. Electronic address: alessandro.sciahbasi@fastwebnet.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciahbasi
authors.affiliation: Division of Cardiology - Department of Cardio-Thoracic Sciences - Second University of Naples.
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabrò
authors.affiliation: HSE Management, Rome.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sarandrea
authors.affiliation: Interventional Cardiology, Sandro Pertini Hospital - ASL RMB, Rome.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rigattieri
authors.affiliation: Department of Cardiology, Infermi Hospital, Rivoli.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomassini
authors.affiliation: La Sapienza University, Rome.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.affiliation: UO Emodinamica e Cardiologia Invasiva, IRCCS, Istituto Clinico Humanitas, Rozzano.
authors.forename: Dennis
authors.initials: D
authors.lastname: Zavalloni
authors.affiliation: Interventional Cardiology, Fatebenefratelli Hospital, Milan.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Cortese
authors.affiliation: Cardiology Unit, Misericordia Hospital, Grosseto.
authors.forename: Ugo
authors.initials: U
authors.lastname: Limbruno
authors.affiliation: Cardiology Department, University of Ferrara; Department of Cardiology.
authors.forename: Matteo
authors.initials: M
authors.lastname: Tebaldi
authors.affiliation: Department of Cardiology, Infermi Hospital, Rivoli.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gagnor
authors.affiliation: Villa Scassi Hospital, Genova.
authors.forename: Paolo
authors.initials: P
authors.lastname: Rubartelli
authors.affiliation: San Martino Hospital, Genova.
authors.forename: Antonio
authors.initials: A
authors.lastname: Zingarelli
authors.affiliation: Thoraxcenter, Rotterdam.
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
mesh_terms: D065638:Absorption, Radiation; D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy*; D000925:Anticoagulants / Q000009:adverse effects; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002985:Clinical Protocols; D017023:Coronary Angiography / Q000009:adverse effects; D005060:Europe; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006493:Heparin / Q000009:adverse effects; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects; D016272:Occupational Health; D010446:Peptide Fragments / Q000009:adverse effects; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000009:adverse effects; D011994:Recombinant Proteins / Q000009:adverse effects; D012107:Research Design; D012307:Risk Factors; D013819:Thermoluminescent Dosimetry; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin
keywords: Dosimetry; Percutaneous coronary intervention; Radiation; Transradial