BACKGROUND: Studies demonstrate an increase in radiation exposure with transradial approach (TRA) when compared with transfemoral approach (TFA) for coronary angiography. Given the learning curve associated with TRA, it is not known if this increased radiation exposure to patients is seen when procedures are performed by experienced operators. METHODS: We retrospectively evaluated 1,696 patients who underwent coronary angiography with or without percutaneous coronary intervention (PCI) by experienced operators at a tertiary center from October 2010 to June 2011. Experienced operators were defined as those that perform >75 PCIs/year with >95% of cases performed using the TRA or TFA approach for ≥5 years. The outcomes of interest were dose area product (DAP) and fluoroscopy time (FT). RESULTS: Of the 1,696 patients, 1,382 (81.5%) were performed by experienced femoral operators using TFA and 314 (18.5%) were performed by experienced radial operators using TRA. Most of these cases (65.4%) were diagnostic only (870 TFA and 240 TRA) with both DAP (6040 [3210-8786] vs 5019 [3377-6869] μGy·m(2), P = .003] and FT [6.2 [4.0-10.3] vs 3.3 [2.6-5.0] minutes, P < .001) significantly higher using TRA versus TFA. For procedures involving PCI, despite similar baseline patient, procedural and lesion characteristics, DAP and FT remained significantly higher using TRA versus TFA (19,649 [11,996-25,929] vs 15,395 [10,078-21,617] μGy·m(2), P = .02 and 22.1 [13.3-31.0] vs. 13.8 [9.8-20.3] minutes, P < .001). CONCLUSIONS: In a contemporary cohort of patients undergoing coronary angiography by experienced operators, TRA was associated with higher radiation exposure when compared with TFA.
BACKGROUND: Studies demonstrate an increase in radiation exposure with transradial approach (TRA) when compared with transfemoral approach (TFA) for coronary angiography. Given the learning curve associated with TRA, it is not known if this increased radiation exposure to patients is seen when procedures are performed by experienced operators. METHODS: We retrospectively evaluated 1,696 patients who underwent coronary angiography with or without percutaneous coronary intervention (PCI) by experienced operators at a tertiary center from October 2010 to June 2011. Experienced operators were defined as those that perform >75 PCIs/year with >95% of cases performed using the TRA or TFA approach for ≥5 years. The outcomes of interest were dose area product (DAP) and fluoroscopy time (FT). RESULTS: Of the 1,696 patients, 1,382 (81.5%) were performed by experienced femoral operators using TFA and 314 (18.5%) were performed by experienced radial operators using TRA. Most of these cases (65.4%) were diagnostic only (870 TFA and 240 TRA) with both DAP (6040 [3210-8786] vs 5019 [3377-6869] μGy·m(2), P = .003] and FT [6.2 [4.0-10.3] vs 3.3 [2.6-5.0] minutes, P < .001) significantly higher using TRA versus TFA. For procedures involving PCI, despite similar baseline patient, procedural and lesion characteristics, DAP and FT remained significantly higher using TRA versus TFA (19,649 [11,996-25,929] vs 15,395 [10,078-21,617] μGy·m(2), P = .02 and 22.1 [13.3-31.0] vs. 13.8 [9.8-20.3] minutes, P < .001). CONCLUSIONS: In a contemporary cohort of patients undergoing coronary angiography by experienced operators, TRA was associated with higher radiation exposure when compared with TFA.
Authors: Francesco Burzotta; Carlo Trani; Mario Attilio Mazzari; Antonella Tommasino; Giampaolo Niccoli; Italo Porto; Antonio Maria Leone; Giovanni Tinelli; Valentina Coluccia; Maria De Vita; Marta Brancati; Rocco Mongiardo; Giovanni Schiavoni; Filippo Crea Journal: Am Heart J Date: 2012-01-13 Impact factor: 4.749
Authors: Francesco Pelliccia; Carlo Trani; Giuseppe G L Biondi-Zoccai; Marco Nazzaro; Andrea Berni; Giuseppe Patti; Roberto Patrizi; Bruno Pironi; Pietro Mazzarotto; Gaetano Gioffrè; Giulio Speciale; Christian Pristipino Journal: Am J Cardiol Date: 2012-05-30 Impact factor: 2.778
Authors: Muhammad Tariq Farman; Naveed Ullah Khan; Jawaid Akber Sial; Tahir Saghir; Syed Nadeem Hasan Rizvi; Khan Shah Zaman Journal: Anadolu Kardiyol Derg Date: 2011-09-29
Authors: Gerritjan Kuipers; Ronak Delewi; Xandra L Velders; Marije M Vis; Rene J van der Schaaf; Karel T Koch; José P S Henriques; Robbert J de Winter; Jan Baan; Jan G P Tijssen; Jan J Piek Journal: JACC Cardiovasc Interv Date: 2012-07 Impact factor: 11.195
Authors: Rebecca Smith-Bindman; Diana L Miglioretti; Eric Johnson; Choonsik Lee; Heather Spencer Feigelson; Michael Flynn; Robert T Greenlee; Randell L Kruger; Mark C Hornbrook; Douglas Roblin; Leif I Solberg; Nicholas Vanneman; Sheila Weinmann; Andrew E Williams Journal: JAMA Date: 2012-06-13 Impact factor: 56.272
Authors: Moritz Seiffert; Francisco Ojeda; Kai Müllerleile; Elvin Zengin; Christoph Sinning; Christoph Waldeyer; Edith Lubos; Ulrich Schäfer; Karsten Sydow; Stefan Blankenberg; Dirk Westermann Journal: Clin Res Cardiol Date: 2015-01-22 Impact factor: 5.460
Authors: Binita Shah; Xingchen Mai; Lakshmi Tummala; Chad Kliger; Sripal Bangalore; Louis H Miller; Steven P Sedlis; Frederick Feit; Michael Liou; Michael Attubato; John Coppola; James Slater Journal: Am J Cardiol Date: 2014-01-15 Impact factor: 2.778