Radiation exposure during percutaneous coronary interventions and coronary angiograms performed by the radial compared with the femoral route

摘要

Objectives: This study aimed to compare radiation exposure of patients undergoing percutaneous coronary interventions (PCI) and coronary angiograms (CAG) accessed by the femoral route with the radial route (operator's choice). Background: There are limited and contradictory data on the radiation exposure of patients during PCI and CAG performed by the radial route compared with the femoral route. Methods: Data on the radiation exposure of patients from 3,973 PCI and CAG procedures between June 22, 2004, and December 31, 2008, were prospectively collected and analyzed. A prediction model was made for radiation exposure (dose-area product in Gy·cm 2) based upon the femoral access group, and the group of radial performed procedures was compared to assess differences between observed and expected radiation exposure. Results: Median exposures of patients undergoing a PCI via the femoral route (n = 2,309) was 75 (interquartile range [IQR]: 44 to 135) Gy·cm 2 compared with 72 (IQR: 42 to 134) Gy·cm 2 for radial performed procedures (n = 1,212) (p = 0.30). Median exposure for CAGs was 44 (IQR: 31 to 69) Gy·cm 2 and 40 (IQR: 25 to 65) Gy·cm 2 for, respectively, femoral (n = 314) and radial performed procedures (n = 138), (p = 0.31). Also, the observed radiation exposure in patients undergoing radial PCI or CAGs was not higher than the expected exposure of patients as predicted by the femoral access-based prediction model (71.5 ± 2.3 Gy·cm 2 vs. 79.9 ± 1.8 Gy·cm 2,). Conclusions: The study shows that even after correction for the complexity of the procedures, selected procedures performed by the radial route are not associated with higher radiation exposure of patients than selected procedures performed by the femoral route.