title: Operator radiation exposure during right or left transradial coronary angiography: A phantom study.
abstract: BACKGROUND
  Previous studies showed a possible lower radiation dose absorbed by operators comparing LRA and RRA for percutaneous coronary procedures. The reasons of this lower radiation dose are not well known. The aim of this study was to evaluate the radiation dose absorbed by operators comparing left with right radial access (LRA and RRA respectively) during a simulated diagnostic coronary angiography using a phantom.
  
  
  METHODS
  A coronary angiography examination was simulated on a phantom by 5 operators using eight projections with 5 seconds fluoroscopy each. Each operator was equipped with 4 electronic dosimeters placed at thorax, at left wrist, at left head and at hip level. Radiation doses were expressed in picosievert and normalized by dose area product.
  
  
  RESULTS
  LRA compared to RRA was associated with a significant lower operator dose at wrist (36pSv/cGYcm(2) [IQR 18-59pSv/cGYcm(2)] and 48pSv/cGYcm(2) [IQR 22-148pSv/cGYcm(2)] respectively, p=0.01) and thorax (3pSv/cGYcm(2) [IQR 2-5pSv/cGYcm(2)] and 10pSv/cGYcm(2) [6-23pSv/cGYcm(2)] respectively, p<0.001) but with a significant higher radiation dose at hip level (102pSv/cGYcm(2) [IQR 44-199pSv/cGYcm(2)] and 67pSv/cGYcm(2) [IQR 39-132pSv/cGYcm(2)] respectively, p=0.02). Conversely the radiation dose at left side of the head did not show significant differences between the two approaches.
  
  
  CONCLUSIONS
  In this phantom study simulating a diagnostic coronarography the use of LRA compared to RRA was associated with a significant lower radiation dose at wrist and thorax but with an increased dose at hip level.
  
  
  CONCLUSIONS
  To evaluate the radiation dose absorbed by operators comparing left with right radial access (LRA and RRA respectively) we simulated a diagnostic coronary angiography using a dedicated phantom. Operators were equipped with dedicated electronic dosimeters at wrist, hip, head and thorax level. LRA compared to RRA was associated with a significant lower operator dose at wrist and thorax but with a significant higher radiation dose at hip level whereas the radiation dose at left side of the head did not show significant differences between the two approaches.
authors.affiliation: Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy. Electronic address: alessandro.sciahbasi@fastwebnet.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciahbasi
authors.affiliation: Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rigattieri
authors.affiliation: HSE Management, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sarandrea
authors.affiliation: Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Cera
authors.affiliation: Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Cristian
authors.initials: C
authors.lastname: Di Russo
authors.affiliation: Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Fedele
authors.affiliation: Cardiology, University of L'Aquila, Rome, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Romano
authors.affiliation: Emergency Department, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Francesco Rocco
authors.initials: FR
authors.lastname: Pugliese
authors.affiliation: Cardiology, University of L'Aquila, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Penco
mesh_terms: D002406:Catheterization, Peripheral / Q000379:methods*; D017023:Coronary Angiography / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects; D016272:Occupational Health; D019047:Phantoms, Imaging; D017534:Radial Artery / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects; D011834:Radiation Monitoring; D018570:Risk Assessment; D012307:Risk Factors
keywords: Left radial; Radiation dose; Right radial; Transradial approach