Comparison of operator radiation exposure with optimized radiation protection devices during coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes

Brasselet, Camille; Blanpain, Thierry; Tassan-Mangina, Sophie; Deschildre, A.; Duval, Sébastien; Vitry, Fabien; Gaillot-Petit, N.; Clément, Jean Paul; Metz, Damien

doi:10.1093/eurheartj/ehm508

Cited by 144 publications

(93 citation statements)

References 14 publications

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“…In our study, significantly high fluoroscopy time of r-CA and r-PCI groups is consistent with previous studies (9,21,22). It may be argued that mean fluoroscopy time of f-CA as well as r-CA is relatively high.…”

Section: Discussionsupporting

confidence: 92%

Comparison of fluoroscopy time during coronary angiography and interventions by radial and femoral routes- can we decrease the fluoroscopy time with increased experience? An observational study

Farman¹,

Khan²,

Sial³

et al. 2011

Anadolu Kardiyol Derg

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Section: Discussionsupporting

confidence: 92%

Comparison of fluoroscopy time during coronary angiography and interventions by radial and femoral routes- can we decrease the fluoroscopy time with increased experience? An observational study

Farman¹,

Khan²,

Sial³

et al. 2011

Anadolu Kardiyol Derg

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“…It has been reported that increased operator radiation exposure during radial access, as opposed to femoral access, is related to increase in FT, reflecting technical difficulties and to the slightly closer operator's position to the x-ray tube and to the patient, compared with femoral access. 5,15,16 In contrast, decreased operator radiation dose and shorter FT have been reported when using LRA compared with RRA. 10,11,17e20 In our study, there are some details in radiation protection techniques that should be taken into consideration: First, during RRA procedures, the leaded glass mobile panel is positioned less proximally to the table compared with LRA and RFA to facilitate the right radial access.…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure of the Operator During Coronary Interventions (from the RADIO Study)

Kallinikou

Puricel

Ryckx

et al. 2016

The American Journal of Cardiology

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We sought to compare operator radiation exposure during procedures using right femoral access (RFA), right radial access (RRA), and left radial access (LRA) during coronary angiography (CA) and percutaneous coronary intervention (PCI). Because of an increased incidence of long-term malignancy in interventional cardiologists, operator radiation exposure is of rising concern. This prospective study included all consecutive patients who underwent elective or emergency CA -PCI from September 2014 to March 2015. The primary end point was operator radiation exposure, quantified as the ratio of operator cumulative dose (CD) and patient radiation reported as dose-area product ( The LRA showed lower CD compared with RRA (p <0.001). There were no significant differences in DAP among the 3 access sites. FT was similar for the 3 groups (RFA 7 -7, RRA 5 -5, LRA 6 -5 minutes, RFA vs RRA: p [ 1, RFA vs LRA: p [ 0.16, RRA vs LRA: p [ 0.52). In conclusion, the use of RFA during CA -PCI is associated with significantly lower operator radiation exposure compared with RRA. LRA is associated with significantly lower operator radiation exposure compared with RRA.Because of a presumably increased stochastic risk of cancer induction among interventional cardiologists, especially neoplasms of the unprotected brain, nasopharyngeal tract, and upper extremities, operator radiation exposure during coronary angiography (CA) and/or percutaneous coronary intervention (PCI) is of rising concern. 1,2 Therefore, we undertook a comparison of operator radiation exposure during right femoral access (RFA), left radial access (LRA), and right radial access (RRA) during CA and CA followed by ad hoc PCI in a real-world population. MethodsFrom September 2014 to March 2015 at the University and Hospital Fribourg, all consecutive procedures of elective or emergency CA and CA followed by ad hoc PCI were prospectively considered for operator radiation exposure measurements. Procedures were performed by 5 senior interventional cardiologists with significant experience (>3,000 PCI each) in both femoral and radial access routes. Selection of the percutaneous access site was left to the discretion of the operator. Crossover access site procedures were excluded. This study was part of the Catheterization Registry Fribourg (CardioFR), which was approved by the Ethics Committee of Canton Vaud (protocol no: 339/14).The primary end point of the study was operator radiation exposure, expressed as the cumulative equivalent dose (in mSv) over the lead apron at chest level, normalized for the patient radiation exposure (dose-area product [DAP] in Gycm 2 ). Secondary end points included cumulative dose (CD), DAP, and fluoroscopy time (FT).Procedures were performed on a digital single-plane cineangiography unit (Allura FD10; Philips Medical Systems, Hamburg, Germany) with an undertable x-ray tube MRC20025 with a magnification factor leading to a field of view of 21 cm and an acquisition frequency of 15 frames/s. All procedures were performed with respect to current guidel...

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“…18 More importantly, a significant amount of radiation scatter from the patients' pelvic bone structures should not be overlooked. 19 Another limitation that cannot be ignored is the small patient population. A larger sample of patients is needed to strengthen the statistical power of this study.…”

Section: Discussionmentioning

confidence: 99%

Randomized comparison of long and short vascular sheaths in reduction of the operator radiation exposure during uterine artery embolization

Cao

Zhang

Zhuang

et al. 2016

BJR

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Comparison of operator radiation exposure with optimized radiation protection devices during coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes

Cited by 144 publications

References 14 publications

Comparison of fluoroscopy time during coronary angiography and interventions by radial and femoral routes- can we decrease the fluoroscopy time with increased experience? An observational study

Comparison of fluoroscopy time during coronary angiography and interventions by radial and femoral routes- can we decrease the fluoroscopy time with increased experience? An observational study

Radiation Exposure of the Operator During Coronary Interventions (from the RADIO Study)

Randomized comparison of long and short vascular sheaths in reduction of the operator radiation exposure during uterine artery embolization

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