Tarighatnia A, Pourafkari L, Farajollahi A, Mohammadalian A H, Ghojazadeh M, Nader N D
Tabriz University of Medical Sciences, Tabriz, Iran.
University at Buffalo, Buffalo, NY, USA.
Herz. 2018 Sep;43(6):535-542. doi: 10.1007/s00059-017-4595-9. Epub 2017 Jul 17.
The right radial artery has gained popularity as the preferred access site for coronary angiography. To save time and limit the radiation exposure of operators and patients, newly designed catheters can be used to access both the right and left coronary arteries. The aim of this study was to compare operator radiation exposure between single-catheter (SCA) and two-catheter approaches (TCA).
In all, 256 patients undergoing diagnostic coronary angiography via the right radial artery in a high-volume medical center were randomized to either the SCA or TCA group. The dose of radiation exposure of the operators was measured by an electronic dosimeter attached to the breast pocket of the operator's apron. The dose-area product and air kerma were used as indices of patient exposure to radiation. The duration of fluoroscopy "beam-on" time, acquisition time, and total duration of the procedure were measured and analyzed for the two groups.
Operator radiation exposure was 21.6 ± 11.4 µSv in the SCA group, which was significantly less than 28.0 ± 14.9 µSv in the TCA group. The duration of fluoroscopy was significantly shorter in the SCA group than in the TCA group (152 ± 83 vs. 203 ± 121 s; p < 0.001). Moreover, the total duration of the diagnostic procedure was also shorter in the SCA group compared with the TCA group (9.5 ± 3.2 vs. 11.4 ± 4.0 min; p < 0.001).
The use of SCA is advantageous over TCA in reducing the exposure of operators to radiation. The shorter duration of fluoroscopy beam-on time and total procedure time may contribute to the lower exposure of operators to radiation.
右桡动脉已成为冠状动脉造影首选的穿刺部位。为节省时间并减少术者和患者的辐射暴露,可使用新设计的导管来进入右冠状动脉和左冠状动脉。本研究的目的是比较单导管(SCA)和双导管方法(TCA)对术者辐射暴露的影响。
在一家大型医疗中心,256例经右桡动脉行诊断性冠状动脉造影的患者被随机分为SCA组或TCA组。通过连接在术者围裙胸袋上的电子剂量仪测量术者的辐射暴露剂量。剂量面积乘积和空气比释动能用作患者辐射暴露的指标。测量并分析两组的透视“射束开启”时间、采集时间和手术总时长。
SCA组术者辐射暴露为21.6±11.4µSv,显著低于TCA组的28.0±14.9µSv。SCA组的透视时长显著短于TCA组(152±83 vs. 203±121秒;p<0.001)。此外,SCA组诊断性手术的总时长也短于TCA组(9.5±3.2 vs. 11.4±4.0分钟;p<0.001)。
在减少术者辐射暴露方面,使用SCA比TCA更具优势。透视射束开启时间和手术总时长较短可能是术者辐射暴露较低的原因。