In:
Texas Heart Institute Journal, Texas Heart Institute Journal, Vol. 50, No. 2 ( 2023-03-1)
Abstract:
The transradial approach (TRA) to coronary angiography reduces vascular complications but is associated with greater radiation exposure than the transfemoral approach (TFA). It is unknown whether exposure remains higher when TRA is performed by experienced operators. Methods Patients were randomly, prospectively assigned to TRA or TFA. The primary end point was patient radiation dose; secondary end points were the physician radiation dose and 30-day major adverse cardiac event rate. Coronary angiography was performed by experienced operators using a standardized protocol. Results Clinical and procedural characteristics were similar between the TRA (n = 150) and TFA (n = 149) groups, and they had comparable mean (SD) radiation doses for patients (616.51 [252] vs 585.57 [225] mGy; P = .13) and physicians (0.49 [0.3] vs 0.46 [0.29] mSv; P = .32). The mean (SD) fluoroscopy time (3.52 [2.02] vs 3.13 [2.46] min; P = .14) and the mean (SD) dose area product (35,496.5 [15,670] vs 38,313.4 [17,764.9] mGy·cm2; P = .2) did not differ. None of the following factors predicted higher radiation doses: female sex (risk ratio [RR], 0.69 [95% CI, 0.38–1.3] ; P = .34), body mass index & gt;25 (RR, 0.84 [95% CI, 0.43–1.6]; P = .76), age & gt;65 years (RR, 1.67 [95% CI, 0.89–3.1]; P = .11), severe valve disease (RR, 1.37 [95% CI, 0.52–3.5] ; P = .68), or previous coronary artery bypass graft (RR, 0.6; 95% CI, 0.2–1.8; P = .38). Conclusion TRA for elective coronary angiography is noninferior to TFA when performed by experienced operators.
Type of Medium:
Online Resource
ISSN:
1526-6702
,
0730-2347
DOI:
10.14503/THIJ-22-7930
Language:
English
Publisher:
Texas Heart Institute Journal
Publication Date:
2023
detail.hit.zdb_id:
2068440-X
Bookmarklink