title: Radiation Exposure of the Operator During Coronary Interventions (from the RADIO Study).
abstract: We sought to compare operator radiation exposure during procedures using right femoral access (RFA), right radial access (RRA), and left radial access (LRA) during coronary angiography (CA) and percutaneous coronary intervention (PCI). Because of an increased incidence of long-term malignancy in interventional cardiologists, operator radiation exposure is of rising concern. This prospective study included all consecutive patients who underwent elective or emergency CA ± PCI from September 2014 to March 2015. The primary end point was operator radiation exposure, quantified as the ratio of operator cumulative dose (CD) and patient radiation reported as dose-area product (DAP) (CD/DAP). Secondary end points included CD, DAP, and fluoroscopy time (FT). Overall 830 procedures (457 CA [55%] and 373 PCI [45%]) were performed, 455 (55%) through RFA, 272 (33%) through RRA, and 103 (12%) through LRA. The CD/DAP was lower in RFA (0.09 μSv/Gycm(2) [0.02 to 0.20]) compared with RRA (0.47 μSv/Gycm(2) [0.25 to 0.75], p <0.001). The LRA showed lower CD/DAP compared with RRA (p <0.001). CD was significantly lower in RFA (3 μSv [1 to 7]) compared with RRA (12 μSv [6 to 29], p <0.001). The LRA showed lower CD compared with RRA (p <0.001). There were no significant differences in DAP among the 3 access sites. FT was similar for the 3 groups (RFA 7 ± 7, RRA 5 ± 5, LRA 6 ± 5 minutes, RFA vs RRA: p = 1, RFA vs LRA: p = 0.16, RRA vs LRA: p = 0.52). In conclusion, the use of RFA during CA ± PCI is associated with significantly lower operator radiation exposure compared with RRA. LRA is associated with significantly lower operator radiation exposure compared with RRA.
authors.affiliation: Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland.
authors.forename: Zacharenia
authors.initials: Z
authors.lastname: Kallinikou
authors.affiliation: Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland.
authors.forename: Serban G
authors.initials: SG
authors.lastname: Puricel
authors.affiliation: Department of Radiology, Institute of Radiophysics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Nick
authors.initials: N
authors.lastname: Ryckx
authors.affiliation: Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Togni
authors.affiliation: Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland.
authors.forename: Gerard
authors.initials: G
authors.lastname: Baeriswyl
authors.affiliation: Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Stauffer
authors.affiliation: Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland.
authors.forename: Stephane
authors.initials: S
authors.lastname: Cook
authors.affiliation: Department of Radiology, Institute of Radiophysics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Francis R
authors.initials: FR
authors.lastname: Verdun
authors.affiliation: Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland. Electronic address: jjgoy@goyman.com.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Goy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D000072096:Cardiologists; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005263:Femoral Artery; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D061646:Operative Time; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D017534:Radial Artery; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D011874:Radiometry; D013997:Time Factors