Operator radiation exposure between left distal and right conventional radial access in patients undergoing PCI
Y Kim, O H Lee, J W Roh, S J Heo, S Y Lee, E Im, D K Cho, J H LeeAbstract
Background
Distal radial access (DRA) has emerged as a promising alternative to conventional transradial access (TRA), potentially reducing vascular complications and enhancing patient comfort. However, evidence on operator radiation exposure during percutaneous coronary intervention (PCI) is currently limited. This study aimed to compare operator radiation exposure between left DRA and right TRA in patients undergoing PCI.
Methods
In this pre-specified subgroup analysis of the prospective, multicenter, randomized DOSE trial (N=1,101) (1), we evaluated 256 patients who underwent PCI, with 139 in the left DRA group and 117 in the TRA group. The primary endpoint was operator radiation exposure (µSv) at the left wrist, head, and chest using real-time dosimeters. Secondary endpoints included access site crossover rate, fluoroscopy time, procedure time, and contrast volume.
Results
Baseline clinical characteristics and PCI complexity were comparable between the two groups, with complex PCI performed in 37.4% of the Left DRA group and 41.9% of the right TRA group. No significant differences were observed in operator radiation exposure to the left wrist (9.28 µSv vs 11.53 µSv, P=0.113), head (4.76 µSv vs 4.65 µSv, P=0.856), and chest (2.38 µSv vs 2.41 µSv, P=0.945) between the left DRA and right TRA groups (Figure 1). The incidence of crossover (5.0% vs. 6.0%, P=0.955), fluoroscopy time (16.3 minutes vs 15.5 minutes, P=0.681), procedure time (50.0 minutes vs 47.0 minutes, P=0.739), and contrast volume (210.0 mL vs 196.0 mL, P=0.245) were not significantly different between the two groups (Figure 2).
Conclusions
In patients undergoing PCI, operator radiation exposure at the left wrist, head, and chest was not significantly different between left DRA and right TRA.Figure1For image description, please refer to the figure legend and surrounding text.Figure2For image description, please refer to the figure legend and surrounding text.