Radiation Exposure with the Radial Approach for Diagnostic Coronary Angiography in a Centre Previously Performing Purely the Femoral Approach

Abstract

Background: Use of the radial approach for coronary angiography and percutaneous coronary intervention (PCI) is known to improve short-term outcomes. However, there is some concern that it may be associated with increased patient radiation exposure. This study explores radiation exposure with the radial approach compared with the femoral approach in a centre previously performing purely femoral approach. Methods: Data was collected retrospectively for all patients undergoing diagnostic coronary angiography over a six-month period (n = 381). PCIs and procedures with inherent technical difficulty or use of additional techniques (graft studies, optical coherence tomography, fractional flow reserve) were excluded. Dose area product (DAP) and fluoroscopy time (FT) were analysed for procedures performed via radial and femoral approaches. Results:Tabled 1ParameterAccessMonths 1–6OverallAve. DAP (mGy cm2)Radial88.286.389.581.360.2103.984.2P = 0.01Femoral71.561.272.179.765.665.869.0Ave. FT (min)Radial6.736.977.396.266.129.877.25P < 0.01Femoral4.404.294.914.724.484.924.61Number of patients707166575265381% radial approach20211839403228 Open table in a new tab Conclusion: The radial approach is associated with significantly higher DAP and FT compared to the femoral approach. Radiation exposure for the radial approach did not decrease over time despite increased use of this approach. This may influence choice of access for diagnostic coronary angiography, particularly for patients more susceptible to radiation risks. Further investigation is required to determine if radiation exposure for the radial approach will improve with more operator experience.