title: Patient radiation exposure in right versus left trans-radial approach for coronary procedures.
abstract: OBJECTIVE
  The aim of this study was to compare radiation exposure, assessed by dose-area product (DAP), in right trans-radial approach (RR) versus left trans-radial approach (LR) for coronary procedures.
  
  
  BACKGROUND
  In LR the catheter course is more similar to trans-femoral approach, thus allowing an easier negotiation of coronary ostia which, in turn, might translate into reduced fluoroscopy time (FT) and radiation exposure as compared to RR.
  
  
  METHODS
  We retrospectively selected diagnostic and interventional procedures (PCI) performed by RR or LR at our center from May 2009 to May 2014. We only included in the analysis the procedures in which DAP values were available.
  
  
  RESULTS
  We analyzed 1464 procedures, 1175 of which performed by RR (80.3%) and 289 by LR (19.7%). Median DAP values were significantly higher in RR as compared to LR for diagnostic and interventional procedures (4482 vs. 3540 cGy.cm(2) and 11523 vs. 10086 cGy.cm(2), respectively; p < 0.05). No significant differences were observed in FT and in contrast volume (CV). In the propensity-matched cohort, consisting of 269 procedures for each group, no significant differences between LR and RR were observed in median DAP values for both diagnostic and interventional procedures (3990 vs. 3542 cGy.cm(2) and 9964 vs. 10216 cGy.cm(2), respectively; p = ns); FT and CV were also similar. At multiple linear regression analysis laterality of trans-radial approach was not associated with DAP.
  
  
  CONCLUSIONS
  In an experienced trans-radial center LR is not associated with a reduction in radiation exposure, FT or CV as compared to RR.
authors.affiliation: Interventional Cardiology Unit, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rigattieri
authors.affiliation: Interventional Cardiology Unit, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Cristian
authors.initials: C
authors.lastname: Di Russo
authors.affiliation: Interventional Cardiology Unit, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Cera
authors.affiliation: Interventional Cardiology Unit, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Fedele
authors.affiliation: Interventional Cardiology Unit, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciahbasi
authors.affiliation: Emergency Department Sandro Pertini Hospital, Rome, Italy.
authors.forename: Francesco Rocco
authors.initials: FR
authors.lastname: Pugliese
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D057216:Propensity Score; D017534:Radial Artery / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D011835:Radiation Protection; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012384:Rome; D013997:Time Factors
keywords: Percutaneous coronary intervention; Radiation exposure; Trans-radial approach