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Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study) [Anatol J Cardiol]
Anatol J Cardiol. 2019; 22(1): 5-12 | DOI: 10.14744/AnatolJCardiol.2019.06013  

Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)

Çağın Mustafa Üreyen1, Kahraman Coşansu2, Mustafa Gökhan Vural2, Sait Emir Şahin3, Ibrahim Kocayigit2, Mustafa Türker Pabuccu2, Muhammed Necati Murat Aksoy2, Mustafa Tarık Ağaç2, Ersan Tatlı2, Hüseyin Gündüz2, Ramazan Akdemir2
1Department of Cardiology, University of Health Sciences, Antalya Education and Research Hospital; Antalya-Turkey
2Department of Cardiology, Sakarya University Education and Research Hospital; Sakarya-Turkey
3Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey

Objective: It is still debatable whether diagnostic coronary angiography (CA) or percutaneous coronary interventions (PCIs) increase radiation exposure when performed via radial approach as compared to femoral approach. This question was investigated in this study by comparison of dose-area product (DAP), reference air kerma (RAK), and fluoroscopy time (FT) among radial and femoral approaches.
Methods: All coronary procedures between November 2015 and November 2017 were assessed; and 4215 coronary procedures were enrolled in the study. Patients with bifurcation, chronic total occlusion, cardiogenic shock, or prior coronary artery bypass surgery were excluded. These 4215 procedures were evaluated for three different categories: diagnostic CA (Group I), PCI in patients with stable angina (Group II), and PCI in patients with ACS (Group III).
Results: Age was significantly higher in the femoral arm of all groups. Among patients in the radial arm of Groups I and II, males were over-represented. Therefore, a multiple linear regression analysis with stepwise method was performed. After adjusting these clinical confounders, there was no significant difference with regard to DAP, RAK, and FT between femoral and radial access in Group I. In contrast, PCI via radial access was significantly associated with increased DAP, RAK, and FT in Groups II and III.
Conclusion: In spite of an increased experience with trans-radial approach, PCI of coronary lesions via radial route was associated with a relatively small but significant radiation exposure in our study. Compared to femoral access, diagnostic CA via radial access was not related to an increased radiation exposure.

Keywords: coronary angiography, femoral artery, percutaneous coronary intervention, radial artery, radiation exposure


Çağın Mustafa Üreyen, Kahraman Coşansu, Mustafa Gökhan Vural, Sait Emir Şahin, Ibrahim Kocayigit, Mustafa Türker Pabuccu, Muhammed Necati Murat Aksoy, Mustafa Tarık Ağaç, Ersan Tatlı, Hüseyin Gündüz, Ramazan Akdemir. Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study). Anatol J Cardiol. 2019; 22(1): 5-12

Corresponding Author: Çağın Mustafa Üreyen, Türkiye


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