Alessandro Sciahbasi1, Paolo Calabrò2, Alessandro Sarandrea3, Stefano Rigattieri4, Francesco Tomassini5, Gennaro Sardella6, Dennis Zavalloni7, Bernardo Cortese8, Ugo Limbruno9, Matteo Tebaldi10, Andrea Gagnor5, Paolo Rubartelli11, Antonio Zingarelli12, Marco Valgimigli13. 1. Interventional Cardiology, Sandro Pertini Hospital - ASL RMB, Rome. Electronic address: alessandro.sciahbasi@fastwebnet.it. 2. Division of Cardiology - Department of Cardio-Thoracic Sciences - Second University of Naples. 3. HSE Management, Rome. 4. Interventional Cardiology, Sandro Pertini Hospital - ASL RMB, Rome. 5. Department of Cardiology, Infermi Hospital, Rivoli. 6. La Sapienza University, Rome. 7. UO Emodinamica e Cardiologia Invasiva, IRCCS, Istituto Clinico Humanitas, Rozzano. 8. Interventional Cardiology, Fatebenefratelli Hospital, Milan. 9. Cardiology Unit, Misericordia Hospital, Grosseto. 10. Cardiology Department, University of Ferrara; Department of Cardiology. 11. Villa Scassi Hospital, Genova. 12. San Martino Hospital, Genova. 13. Thoraxcenter, Rotterdam.
Abstract
BACKGROUND: Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. METHODS: The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. CONCLUSIONS: The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes.
RCT Entities:
BACKGROUND:Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. METHODS: The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. CONCLUSIONS: The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes.
Authors: Ahmed A Kolkailah; Rabah S Alreshq; Ahmed M Muhammed; Mohamed E Zahran; Marwah Anas El-Wegoud; Ashraf F Nabhan Journal: Cochrane Database Syst Rev Date: 2018-04-18
Authors: Francesco Costa; Sara Ariotti; Marco Valgimigli; Philippe Kolh; Stephan Windecker Journal: J Cardiovasc Transl Res Date: 2015-05-19 Impact factor: 4.132