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Radiation exposure levels according to vascular access sites during PCI

A prospective controlled study

Strahlenexpositionsdosen je nach Gefäßpunktionsort bei PCI

Eine prospektive kontrollierte Studie

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Abstract

Background

We previously showed that using the radial artery access site as opposed to the femoral artery site decreases the radiation exposure of patients during coronary artery interventions. The objective of this study was to compare radiation exposure levels of the operating physician during coronary interventions when incorporating both radial and femoral artery approaches.

Methods

The study assessed all coronary angioplasties performed in a major metropolitan general hospital. The study design was prospective and observational, in which we measured the radiation exposure of the patient and the operator. Measurements of radiation levels were made using an electronic personal dosimeter (Diamentor® E2-DAP) at the radial and at the femoral artery access sites. An interventional cardiologist operator performed all the percutaneous coronary interventions (PCI) using a single-plane angiography unit via both femoral and radial artery approaches.

Results

Data from 252 PCIs were recorded. The mean physician radiation exposure levels from the femoral access site and the right radial access site were 40.5 ± 20.2 µSv and 47.5 ± 26.5 µSv, respectively (p < 0.02). There was a strong correlation between physician and patient radiation exposure levels. However, there was no correlation between patient body mass index and radiation exposure levels.

Conclusion

We found significantly higher physician radiation exposure levels with the radial artery than with the femoral artery access site.

Zusammenfassung

Hintergrund

Die Autoren haben bereits früher nachgewiesen, dass durch Nutzung der A. radialis als Zugangslokalisation im Gegensatz zur A. femoralis die Strahlenbelastung der Patienten bei Koronarinterventionen sinkt. Ziel der vorliegenden Arbeit war es, die Strahlenexpositionsdosen des Operateurs während der Koronarintervention sowohl bei Verwendung eines Radial- als auch bei Nutzung eines Femoralarterienzugangs zu untersuchen.

Methoden

Es wurden alle Koronarinterventionen untersucht, die in einem bedeutenden großstädtischen Allgemeinkrankenhaus erfolgten. Im Design handelte es sich um eine prospektive Beobachtungsstudie, in der die Strahlenbelastung von Patient und Operateur gemessen wurde. Die Messung der Strahlendosen erfolgte unter Verwendung eines elektronischen Personendosimeters (Diamentor® E2-DAP) am Ort des Zugangs zur Radial- bzw. zur Femoralarterie. Ein interventionell tätiger Kardiologe führte alle perkutanen Koronarinterventionen (PCI) unter Einsatz eines monoplanen Angiographiesystems via Femoral- oder Radialarterienzugang durch.

Ergebnisse

Die Daten von 252 PCI wurden dokumentiert. Die durchschnittliche Strahlenexpositionsdosis des Arztes betrug bei Zugang über die Femoralarterie 40,5 ± 20,2 µSv bzw. bei Zugang über die rechte Radialarterie 47,5 ± 26,5 µSv, (p < 0,02). Es bestand eine starke Korrelation der Strahlenexpositionsdosen von Arzt und Patient. Jedoch fand sich keine Korrelation zwischen dem Body-Mass-Index des Patienten und den Strahlenexpositionsdosen.

Schlussfolgerung

Bei einem Zugang über die Radialarterie stellten die Autoren signifikant höhere Strahlenbelastungsdosen des Arztes fest als bei einem Zugang über die A. femoralis.

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Authors and Affiliations

  1. Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    A. Tarighatnia

  2. Department of Medical Physics, Tabriz University of Medical Sciences, Tabriz, Iran

    A. R. Farajollahi

  3. Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    M. Ghojazadeh

  4. Interventional Cardiology Unit, Aalinasab Hospital, Tabriz, Iran

    A. Tarighatnia & A. H. Mohammadalian

  5. Sir Thomas Roddick Hospital, NL A2N 1H0, Stephenville, Canada

    M. Azadeh

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

    E. Koleini &  N. D. Nader MD, PhD, FACC, FCCP

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  1. A. Tarighatnia
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  2. A. R. Farajollahi
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  3. A. H. Mohammadalian
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  4. M. Ghojazadeh
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  7. N. D. Nader MD, PhD, FACC, FCCP
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Corresponding author

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

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Conflict of interest

A. Tarighatnia, A.R. Farajollahi, A.H. Mohammadalian, M. Ghojazadeh, M. Azadeh, E. Koleini, 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. Informed consent was obtained from all individual participants included in the study.

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Tarighatnia, A., Farajollahi, A.R., Mohammadalian, A.H. et al. Radiation exposure levels according to vascular access sites during PCI. Herz 44, 330–335 (2019). https://doi.org/10.1007/s00059-017-4639-1

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  • DOI: https://doi.org/10.1007/s00059-017-4639-1

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