Abstract 18517: Meta-Analysis of Radiation Exposure With Transradial versus Transfemoral Access for Diagnostic Coronary Angiography and Percutaneous Coronary Intervention

Abstract

Background: Transradial (TR) access for cardiac catheterization offers advantages over conventional transfemoral (TF) access by reducing bleeding and vascular complications. However, concerns exist regarding potential increased radiation exposure with TR access. The benefit-risk profile due to increased radiation exposure by this technique remains uncertain. We compared radiation exposure for diagnostic coronary angiograms (DCA) and percutaneous coronary interventions (PCI) between TR and TF access. Methods: We searched PubMed, Google Scholar, and Scopus through May 2023 for randomized control trials and observational studies comparing radiation parameters for TR and TF access sites. We compared fluoroscopy time (FT, min) and kerma-area product. The summary estimate was random-effects weighted mean differences (WMDs) with 95% confidence intervals. Results: A total of 33 studies (n = 89,366) were included in the analysis. TR was associated with increased FT (WMD 0.94 [0.61, 1.27] p<0.01) vs. TF access, which was consistent for both DCA (WMD 0.71 [0.20, 23]) and PCI subgroups (WMD 1.09 [0.61, 1.58]) (p for interaction = 0.29). There were no significant differences for the kerma-area product (WMD -0.20 [-0.59, 0.19], p=0.32) between the two access sites, consistent for both DCA (WMD -0.04 [-0.40, 0.32]) and PCI (WMD -0.32 [-0.59, 0.19]) (p for interaction = 0.51) as shown in Figure 1 . Conclusion: TR was associated with increased FT; however, the two access sites had no significant differences concerning kerma-area products.