Effect of Radial Versus Femoral Access on Radiation Dose and the Importance of Procedural Volume
| Autor: | Sanjit S. Jolly, Petr Widimsky, Kari Niemelä, Barbara Jedrzejowski, Warren J. Cantor, Tej Sheth, Sunil V. Rao, Madhu K. Natarajan, Asim N. Cheema, Vicent Valentin, John A. Cairns, Philippe Gabriel Steg, Shamir R. Mehta, Anthony Fung, Peggy Gao, Andrzej Budaj, Rival Investigators, Vladimír Džavík, E. Ferrari |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test Unstable angina business.industry medicine.medical_treatment Radiation dose Percutaneous coronary intervention 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences Kerma 0302 clinical medicine Femoral access Conventional PCI medicine Fluoroscopy 030212 general & internal medicine Myocardial infarction Radiology Cardiology and Cardiovascular Medicine business Nuclear medicine |
| Zdroj: | JACC: Cardiovascular Interventions. 6:258-266 |
| ISSN: | 1936-8798 |
| Popis: | Objectives The authors sought to compare the radiation dose between radial and femoral access. Background Small trials have shown an increase in the radiation dose with radial compared with femoral access, but many were performed during the operators9 learning curve of radial access. Methods Patients were randomized to radial or femoral access, as a part of the RIVAL (RadIal Vs. femorAL) trial (N = 7,021). Fluoroscopy time was prospectively collected in 5740 patients and radiation dose quantified as air kerma in 1,445 patients and dose-area product (DAP) in 2,255 patients. Results Median fluoroscopy time was higher with radial versus femoral access (9.3 vs. 8.0 min, p Conclusions Radiation dose as measured by air kerma was nominally higher with radial versus femoral access, but differences were present only in lower-volume centers and operators. High-volume centers have the lowest radiation dose irrespective of which access site approach that they use. (A Trial of Trans-radial Versus Trans-femoral Percutaneous Coronary Intervention (PCI) Access Site Approach in Patients With Unstable Angina or Myocardial Infarction Managed With an Invasive Strategy [RIVAL]; NCT01014273) |
| Databáze: | OpenAIRE |
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