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background: Although the transradial approach had significantly reduced vascular complications, studies have demonstrated that it may be related to higher radiation exposure. The objective of this study is to compare radiation exposure in invasive cardiologic procedures using the transradial and transfemoral approaches. Methods: Prospective cohort study including patients undergoing diagnostic cardiac catheterization or percutaneous coronary intervention (PCI) between August 2010 and December 2011. Clinical, angiographic and radiation exposure characteristics were recorded in a dedicated database. Patients were analyzed according to the access route: femoral or radial. Results: Of the 1,197 patients included in the study, 782 were submitted to procedures using the femoral access and 415 using the radial access. There was a lower prevalence of females (36.2% vs. 45.6%; P < 0.01), previous coronary artery bypass graft surgery (4% vs. 12.7%; P < 0.01) and severe valvular heart disease (0.3% vs. 1.4%; P = 0.07) in the radial group. The median radiation dose received by the patients was higher with the radial approach, both for diagnostic (621.6 mGy vs 445.7 mGy; P < 0.01) and therapeutic procedures (1,241.6 mGy vs 990.9 mGy; P < 0.01). Less experienced operators in the radial approach exposed patients to higher radiation doses (1,463 mGy vs 1,196 mGy; P = 0.02), which did not occur with the more experienced operators (1,311 mGy vs 1,449 mGy; P = 0.84). Conclusions: Patients undergoing invasive cardiologic procedures are exposed to higher radiation levels when the

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Background: Invasive cardiac procedures expose patients and physicians to ionising radiation. The aim of this study was to determine the impact of body weight on radiation exposure during cardiac procedures. Methods: A prospective cohort study of patients undergoing cardiac catheterisation or percutaneous coronary intervention (PCI) between August of 2010 and December of 2011. Clinical, angiographic, and radiation exposure characteristics were recorded in a dedicated database. Radiation exposure patterns were established in three groups: A (≤ 79 kg), B (80-99 kg), and C (≥ 100 kg). Data were analysed using the Statistical Package for Social Sciences (SPSS), version 18.0, and the results were presented as the mean, standard deviation, percentage, percentile, and interquartile interval. The independent predictors of increased radiation exposure were identified using a multiple logistic regression analysis. Results: The sample included a total of 671 patients, 363 in group A, 252 in group B, and 56 in group C. The mean dose of radiation exposure was 484.29 mGy, 735.69 mGy, and 900.36 mGy for groups A, B, and C, respectively (P < 0.001). The median dose area product was 29.327 mGy.cm², 43.319 mGy.cm², and 57.987 mGy.cm² for groups A, B, and C, respectively (P < 0.001). The predictors of increased radiation exposure were weight (odds ratio [OR] 1.03, confidence interval [CI] 1.01-1.05, P = 0.003), confidence interval (CI) 1.01-1.05, P = 0.003], elective PCI (OR 11.9, CI 4.26-33.24, P < 0.001), and ad hoc PCI (OR 15.46,.87, P < 0.001). Conclusions: Patient weight has a significant impact on radiation exposure during invasive cardiac procedures. Overweight patients are significantly more exposed to higher doses of ionising radiation.

Background: Invasive cardiologic procedures expose physicians and nurses/technicians to the risks of ionizing radiation. The aim of this study was to determine the exposure patterns in healthcare professionals during cardiologic procedures. Methods: Prospective study including patients undergoing invasive cardiologic procedures between December 2011 and August 2012 using flat-panel detector fluoroscopy. Clinical, angiographic and radiation exposure characteristics were recorded in a dedicated database. Patterns of radiation exposure were determined in patients undergoing diagnostic cardiac catheterization. The correlation between surgeon and nurse/technician dose was also evaluated. Results: The sample included 119 patients undergoing catheterization. The patient mean air kerma dose and dose-area product was 549 ± 220 mGy and 29,054 ± 14,696 mGy.cm², respectively. Physicians and nurses/technicians were exposed to a mean effective dose of 0.47 ± 0.16 and 0.28 ± 0.13 mSv per exam, respectively. The correlation between physicians and nurses/technicians effective dose was 0.54 (p < 0.001). Conclusions: Physicians and nurses/technicians are exposed to low ionizing radiation doses during diagnostic cardiac catheterization. Nurses/technicians are exposed to approximately 60% of the operating physician's dose.

Background The transradial approach (TRA) to coronary angiography reduces vascular complications but is associated with greater radiation exposure than the transfemoral approach (TFA). It is unknown whether exposure remains higher when TRA is performed by experienced operators. Methods Patients were randomly, prospectively assigned to TRA or TFA. The primary end point was patient radiation dose; secondary end points were the physician radiation dose and 30-day major adverse cardiac event rate. Coronary angiography was performed by experienced operators using a standardized protocol. Results Clinical and procedural characteristics were similar between the TRA (n = 150) and TFA (n = 149) groups, and they had comparable mean (SD) radiation doses for patients (616.51 [252] vs 585.57 [225] mGy; P = .13) and physicians (0.49 [0.3] vs 0.46 [0.29] mSv; P = .32). The mean (SD) fluoroscopy time (3.52 [2.02] vs 3.13 [2.46] min; P = .14) and the mean (SD) dose area product (35,496.5 [15,670] vs 38,313.4 [17,764.9] mGy·cm2; P = .2) did not differ. None of the following factors predicted higher radiation doses: female sex (hazard ratio [HR], 0.69 [95% CI, 0.38–1.3]; P = .34), body mass index &gt;25 (HR, 0.84 [95% CI, 0.43–1.6]; P = .76), age &gt;65 years (HR, 1.67 [95% CI, 0.89–3.1]; P = .11), severe valve disease (HR, 1.37 [95% CI, 0.52–3.5]; P = .68), or previous coronary artery bypass graft (HR, 0.6; 95% CI, 0.2–1.8; P = .38). Conclusion TRA for elective coronary angiography is noninferior to TFA when performed by experienced operators.

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