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Operator radiation exposure during transradial coronary angiography

Effect of single vs. double catheters

Strahlenexposition des Untersuchers bei transradialer Koronarangiographie

Einfluss von Einzel- vs. Doppelkatheter

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Abstract

Background

The right radial artery has gained popularity as the preferred access site for coronary angiography. To save time and limit the radiation exposure of operators and patients, newly designed catheters can be used to access both the right and left coronary arteries. The aim of this study was to compare operator radiation exposure between single-catheter (SCA) and two-catheter approaches (TCA).

Methods

In all, 256 patients undergoing diagnostic coronary angiography via the right radial artery in a high-volume medical center were randomized to either the SCA or TCA group. The dose of radiation exposure of the operators was measured by an electronic dosimeter attached to the breast pocket of the operator’s apron. The dose–area product and air kerma were used as indices of patient exposure to radiation. The duration of fluoroscopy “beam-on” time, acquisition time, and total duration of the procedure were measured and analyzed for the two groups.

Results

Operator radiation exposure was 21.6 ± 11.4 µSv in the SCA group, which was significantly less than 28.0 ± 14.9 µSv in the TCA group. The duration of fluoroscopy was significantly shorter in the SCA group than in the TCA group (152 ± 83 vs. 203 ± 121 s; p < 0.001). Moreover, the total duration of the diagnostic procedure was also shorter in the SCA group compared with the TCA group (9.5 ± 3.2 vs. 11.4 ± 4.0 min; p < 0.001).

Conclusion

The use of SCA is advantageous over TCA in reducing the exposure of operators to radiation. The shorter duration of fluoroscopy beam-on time and total procedure time may contribute to the lower exposure of operators to radiation.

Zusammenfassung

Hintergrund

Die rechte A. radialis wird zunehmend als bevorzugte Zugangsstelle für die Koronarangiographie verwendet. Um Zeit zu sparen und die Strahlenexposition von Untersuchern und Patienten zu begrenzen, können neu entwickelte Katheter für den Zugang sowohl zur rechten als auch zur linken Koronararterie eingesetzt werden. Ziel der vorliegenden Studie war es, die Strahlenexposition des Untersuchers zwischen Einzelkatheter- und Doppelkathetereinsatz zu vergleichen.

Methoden

Insgesamt wurden 256 Patienten, bei denen eine diagnostische Koronarangiographie über die rechte A. radialis in einem medizinischen Zentrum mit hohem Durchsatz erfolgte, randomisiert entweder der Einzel- oder der Doppelkathetergruppe zugeteilt. Mit einem elektronischen Dosimeter, das an der Brusttasche der Untersucherschürze befestigt war, wurde die Dosis der Strahlenexposition des Untersuchers gemessen. Das Dosis-Flächen-Produkt und die Luftkerma wurden als Indizes der Strahlenexposition des Patienten verwendet. Für beide Gruppen wurden die Dauer der Durchleuchtungszeit mit eingeschaltetem Röntgenstrahl, die Aufnahmedauer und die Gesamtdauer der Untersuchung erfasst und ausgewertet.

Ergebnisse

Die Strahlenbelastung des Untersuchers betrug in der Einzelkathetergruppe 21,6 ± 11,4 µSv und war somit signifikant geringer als der Wert von 28,0 ± 14,9 µSv in der Doppelkathetergruppe. Auch war die Durchleuchtungsdauer in der Einzelkathetergruppe signifikant kürzer als in der Doppelkathetergruppe (152 ± 83 vs. 203 ± 121 s; p < 0,001). Außerdem war auch die Gesamtdauer der Untersuchung in der Einzelkathetergruppe kürzer als in der Doppelkathetergruppe (9,5 ± 3,2 vs. 11,4 ± 4,0 min; p < 0,001).

Schlussfolgerung

Die Verwendung von Einzelkathetern ist gegenüber dem Einsatz von Doppelkathetern vorteilhaft, da so die Strahlenexposition des Untersuchers verringert ist. Zur geringeren Strahlenexposition der Untersucher tragen möglicherweise auch die kürzere Dauer der Durchleuchtungszeit mit eingeschaltetem Röntgenstrahl und der Gesamtuntersuchungszeit bei.

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Authors and Affiliations

  1. Tabriz University of Medical Sciences, Tabriz, Iran

    A. Tarighatnia MSc

  2. University at Buffalo, Buffalo, NY, USA

    L. Pourafkari MD, FACC

  3. Tabriz University of Medical Sciences, Tabriz, Iran

    A. Farajollahi PhD

  4. Aalinasab Hospital, Tabriz University of Medical Sciences, Tabriz, Iran

    A. H. Mohammadalian MD

  5. Research Center for Evidence-Based Medicine, University of Medical Sciences, Tabriz, Iran

    M. Ghojazadeh MD, PhD, MPH

  6. Department of Anesthesiology, Gateway Building, University at Buffalo, 77 Goodell Street, Suite 550, 14203, Buffalo, NY, USA

    N. D. Nader MD, PhD, FACC, FCCP

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  1. A. Tarighatnia MSc
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  2. L. Pourafkari MD, FACC
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  4. A. H. Mohammadalian MD
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Correspondence to N. D. Nader MD, PhD, FACC, FCCP.

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Conflict of interest

A. Tarighatnia, L. Pourafkari, A. Farajollahi, A.H. Mohammadalian, M. Ghojazadeh, and N.D. Nader declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Tarighatnia, A., Pourafkari, L., Farajollahi, A. et al. Operator radiation exposure during transradial coronary angiography. Herz 43, 535–542 (2018). https://doi.org/10.1007/s00059-017-4595-9

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  • DOI: https://doi.org/10.1007/s00059-017-4595-9

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