Operator Radiation Exposure in PTCA: Comparison of Radial and Femoral Approaches

In order to evaluate the radiation risk associated with PTCA from the right radial approach, operator radiation exposure was prospectively measured in 138 patients (pts) undergoing PTCA from the radial artery approach and in 126 patients from the femoral artery approach. Standard overhead and side table lead curtain shields were used in the femoral group and radial group I (66 pts). In radial group II (72 pts), a movable floor shield was added to the procedure for additional radiation protection. The external whole body dose was measured monthly using film dosimeters. Dose per case and dose per minute of fluoroscopy time were calculated. Operator external whole body dose was significantly higher when PTCA is performed from the radial artery (13.5 +/- 2.1 mrem/case) as compared to the femoral artery (8.8 +/- 1.3 mrem/case) approach (p <.01). This increased radiation exposure was reduced to less than the femoral artery when the movable floor shield is added to standard x-ray protection (3.3 +/- 2.3 mrem/case, p <.01 vs. femoral). Thus, PTCA can be performed from the radial artery approach without increased operator radiation exposure.