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

IF 6.1 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Circulation: Cardiovascular Interventions Pub Date : 2025-03-19 DOI:10.1161/CIRCINTERVENTIONS.124.014602

Richard Casazza, Bilal Malik, Arsalan Hashmi, Joshua Fogel, Enrico Montagna, Robert Frankel, Elliot Borgen, Sergey Ayzenberg, Michael Friedman, Norbert Moskovits, Shivani Verma, Jamie Meng, Nailun Chang, Yili Huang, Carlos Rodriguez, Habib Hymie Chera, Shiv Raj, Saurav Chaterjee, Daren Gibson, Andres Palacios, Chirag Agarwal, Maria Victoria Nene, Jacob Shani

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Abstract

Background: Radiation exposure is one of the most adverse occupational hazards faced by interventional cardiologists. Various arterial access sites have shown to yield different operator radiation exposure during diagnostic cardiac catheterization.

Methods: This single-center randomized controlled trial assessed the cumulative radiation exposure and normalized radiation exposure at 4 different anatomic locations (thorax, abdomen, left eye, and right eye) of the primary operator when using the left radial artery (LRA) approach compared with a uniform hyper-adducted right radial artery (HARRA) approach. Patients (n=534) were randomized to LRA (n=269) or HARRA (n=265). During diagnostic catheterization, real-time radiation dosimeters were placed on the thorax, abdomen, left eye, and right eye of each operator.

Results: Cumulative radiation measurements were as follows: thorax (LRA, 9.66±8.57 microsieverts [μSv] versus HARRA, 12.27±7.09 μSv; P<0.001); abdomen (LRA, 27.46±21.20 μSv versus HARRA, 36.56±23.72 μSv; P<0.001); left eye (LRA, 2.65±2.59 μSv versus HARRA, 3.77±2.67 μSv; P<0.001); and right eye (LRA, 1.13±1.69 μSv versus HARRA, 1.44±1.62 μSv; P=0.01). Normalized radiation measurements were: thorax (LRA, 0.38±0.35 versus HARRA, 0.49±0.24; P<0.001); abdomen (LRA, 1.06±0.72 versus HARRA, 1.38±0.69; P<0.001); left eye (LRA, 0.10±0.09 versus HARRA, 0.15±0.10; P<0.001); and right eye: (LRA, 0.04±0.06 versus HARRA, 0.05±0.06; P=0.02). LRA had lower subclavian tortuosity than HARRA (15.6% versus 32.5%, P<0.001).

Conclusions: The LRA was associated with significantly less cumulative and normalized radiation exposure to the thorax, abdomen, left eye, and right eye of the primary operator compared with HARRA during diagnostic cardiac catheterization. Operators should consider using LRA more frequently than HARRA for diagnostic cardiac catheterization as this approach can reduce occupational radiation exposure.

Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05833516.

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来源期刊

Circulation: Cardiovascular Interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

1.80%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Circulation: Cardiovascular Interventions, an American Heart Association journal, focuses on interventional techniques pertaining to coronary artery disease, structural heart disease, and vascular disease, with priority placed on original research and on randomized trials and large registry studies. In addition, pharmacological, diagnostic, and pathophysiological aspects of interventional cardiology are given special attention in this online-only journal.