Operator Radiation Exposure Comparing the Left Radial Artery Approach and a Uniform Hyper-Adducted Right Radial...

Area of Science:

• Interventional Cardiology
• Occupational Health
• Radiation Safety

Background:

• Interventional cardiologists face significant occupational radiation exposure risks.
• Arterial access site selection impacts operator radiation dose during cardiac catheterization.

Purpose of the Study:

• To compare radiation exposure to the operator using the left radial artery (LRA) versus the uniform hyper-adducted right radial artery (HARRA) approach.
• To assess cumulative and normalized radiation doses at the thorax, abdomen, and eyes.

Main Methods:

• Single-center randomized controlled trial involving 534 patients.
• Operators were randomized to either LRA or HARRA approach for diagnostic cardiac catheterization.
• Real-time radiation dosimeters measured exposure on the operator's thorax, abdomen, and eyes.

Main Results:

• The LRA approach resulted in significantly lower cumulative and normalized radiation exposure across all measured locations (thorax, abdomen, left eye, right eye) compared to HARRA (P<0.001 for thorax and abdomen).
• Subclavian tortuosity was also lower with the LRA approach (15.6% vs. 32.5%, P<0.001).

Conclusions:

• The LRA approach is associated with substantially reduced occupational radiation exposure for interventional cardiologists.
• Increased utilization of the LRA approach for diagnostic cardiac catheterization is recommended to enhance operator safety.