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

Area of Science:

• Interventional Cardiology
• Radiation Safety
• Medical Imaging

Background:

• Operator radiation exposure during coronary angiography (CA) and percutaneous coronary intervention (PCI) is a growing concern due to increased long-term malignancy risks in interventional cardiologists.
• Choosing the optimal vascular access site is crucial for minimizing radiation dose to healthcare professionals.

Purpose of the Study:

• To prospectively compare operator radiation exposure across three vascular access sites: right femoral access (RFA), right radial access (RRA), and left radial access (LRA) during CA and PCI procedures.
• To identify the access site associated with the lowest operator radiation dose.

Main Methods:

• A prospective study involving 830 consecutive patients undergoing elective or emergency CA ± PCI.
• Operator radiation exposure was quantified using the ratio of cumulative dose (CD) to patient dose-area product (DAP) (CD/DAP).
• Secondary endpoints included CD, DAP, and fluoroscopy time (FT).

Main Results:

• The CD/DAP ratio was significantly lower for RFA (0.09 μSv/Gycm(2)) compared to RRA (0.47 μSv/Gycm(2)) (p < 0.001).
• LRA also demonstrated a lower CD/DAP ratio compared to RRA (p < 0.001).
• RFA showed significantly lower operator cumulative dose (CD) (3 μSv) compared to RRA (12 μSv) (p < 0.001), with LRA also showing lower CD than RRA.

Conclusions:

• Right femoral access (RFA) is associated with significantly lower operator radiation exposure during CA ± PCI compared to right radial access (RRA).
• Left radial access (LRA) also provides lower operator radiation exposure compared to RRA.
• These findings suggest RFA and LRA as potentially safer alternatives for interventional cardiologists regarding radiation exposure.