Evaluation of radiological risk during coronary angioplasty procedures: comparison of transradial and transfemoral approaches

Abstract

Increasing operator experience and newer available interventional cardiology devices require reassessment of radiological risk related to percutaneous coronary interventions (PCI). We aimed at comparison of radiological risk and procedural data of PCIs performed by radial (RA) and femoral (FA) approach in real life patients. Detailed retrospective analysis of 1500 consecutive PCIs with the use of radial or femoral access was performed. Comparison between RA and FA groups included procedural time (PT), fluoroscopy time (FT), radiation dose and contrast volume usage. There was no significant differences between RA and FA procedures in FT (12.6 ± 13.5 vs. 11.7 ± 9.5 min), X-ray dose generated during PCI (805.9 ± 615.9 vs. 792.2 ± 633.9 mGy) and use of contrast medium (145.2 ± 62.2 vs. 152.5 ± 64.2 ml). Mean total PT was shorter in RA (43.7 ± 24.5 min) than in FA group (47.2 ± 30.13 min, p < 0.02). Patients’ age positively correlated with FT (r = 0.14, p < 0.05) and PT (r = 0.07, p < 0.05) in RA but not in FA group (r = 0.05; r = −0.06, respectively). Despite younger age, PCIs in males needed higher usage of contrast medium (151.7 ± 69.2 vs. 139.1 ± 49.3 ml; p < 0.001), and higher X-ray dose (887.0 ± 660.4 vs. 657.8 ± 515.2 mGy; p < 0.001). Age significantly correlated with PT only in female (r = 0.093, p < 0.05) but not in male patients (r = 0.015). We conclude that fluoroscopy times, X-ray dose and use of contrast medium were similar in RA and FA, but mean total procedural time was significantly shorter in RA than in FA group. However, older patients in RA group needed longer fluoroscopy and procedural times to complete PCI and this was not seen in FA.

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Citation
Int J Cardiovasc Imaging. 2017 Mar 31.