0368: Radiation in transfemoral versus transradial access in diagnostic coronary angiography

Abstract

Although transradial access (TRA) is being increasingly used in interventional cardiology, there are concerns about a possible increase in radiation exposure as compared to transfemoral access (TFA). The aim of this study is the comparison of radiation exposure parameters between coronary angiography procedures performed via left radial artery, right radial artery or femoral artery and the detection of factors that contribute to increased radiation dose. We analysed collected data on radiation exposure for a total of 733 consecutive diagnostic coronary angiographies (69% in men) excluded those concerning patients with aortocoronary bypass grafts or those accompanied by aortography or ventriculography. Dose area product (DAP) and fluoroscopy time (FT) were used as a means of radiation exposure measurement. The mean patients’ age was 66.8±10.1 years and BMI 28.4±4.6kg/m 2 . Femoral access was used in 45% of the procedures, right radial access (RRA) in 42% and left radial access (LRA) in 13%. More diagnostic catheters were used via TFA than TRA (2.24±0.63 vs 1.94±0.83 respectively, p<0.001); LRA was associated with the use of more diagnostic catheters than RRA. TRA was associated with increased FT (4.8±3.5 vs 3.1±2.4 min, p<0.001 but there was no difference regarding FT between RRA and LRA. Hypertension and the presence of ascending aorta aneurysm were predictors of increased exposure parameters, especially in TRA, whereas diabetes mellitus was predictor of increased DAP. The use of 1 or 2 diagnostic catheters was associated with reduced DAP and FT. TRA is associated with increased FT. Hypertension and ascending aorta aneurysm are adversely affecting exposure parameters. With TRA and especially RRA is feasible the use of fewer diagnostic catheters in patients undergoing diagnostic coronary angiography.