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Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)

OBJECTIVE: It is still debatable whether diagnostic coronary angiography (CA) or percutaneous coronary interventions (PCIs) increase radiation exposure when performed via radial approach as compared to femoral approach. This question was investigated in this study by comparison of dose-area product...

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Autores principales: Üreyen, Çağın Mustafa, Coşansu, Kahraman, Vural, Mustafa Gökhan, Şahin, Sait Emir, Kocayiğit, İbrahim, Pabuccu, Mustafa Türker, Aksoy, Muhammed Necati Murat, Ağaç, Mustafa Tarık, Tatlı, Ersan, Gündüz, Hüseyin, Akdemir, Ramazan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683214/
https://www.ncbi.nlm.nih.gov/pubmed/31264653
http://dx.doi.org/10.14744/AnatolJCardiol.2019.06013
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author Üreyen, Çağın Mustafa
Coşansu, Kahraman
Vural, Mustafa Gökhan
Şahin, Sait Emir
Kocayiğit, İbrahim
Pabuccu, Mustafa Türker
Aksoy, Muhammed Necati Murat
Ağaç, Mustafa Tarık
Tatlı, Ersan
Gündüz, Hüseyin
Akdemir, Ramazan
author_facet Üreyen, Çağın Mustafa
Coşansu, Kahraman
Vural, Mustafa Gökhan
Şahin, Sait Emir
Kocayiğit, İbrahim
Pabuccu, Mustafa Türker
Aksoy, Muhammed Necati Murat
Ağaç, Mustafa Tarık
Tatlı, Ersan
Gündüz, Hüseyin
Akdemir, Ramazan
author_sort Üreyen, Çağın Mustafa
collection PubMed
description OBJECTIVE: It is still debatable whether diagnostic coronary angiography (CA) or percutaneous coronary interventions (PCIs) increase radiation exposure when performed via radial approach as compared to femoral approach. This question was investigated in this study by comparison of dose-area product (DAP), reference air kerma (RAK), and fluoroscopy time (FT) among radial and femoral approaches. METHODS: All coronary procedures between November 2015 and November 2017 were assessed; and 4215 coronary procedures were enrolled in the study. Patients with bifurcation, chronic total occlusion, cardiogenic shock, or prior coronary artery bypass surgery were excluded. These 4215 procedures were evaluated for three different categories: diagnostic CA (Group I), PCI in patients with stable angina (Group II), and PCI in patients with ACS (Group III). RESULTS: Age was significantly higher in the femoral arm of all groups. Among patients in the radial arm of Groups I and II, males were over-represented. Therefore, a multiple linear regression analysis with stepwise method was performed. After adjusting these clinical confounders, there was no significant difference with regard to DAP, RAK, and FT between femoral and radial access in Group I. In contrast, PCI via radial access was significantly associated with increased DAP, RAK, and FT in Groups II and III. CONCLUSION: In spite of an increased experience with trans-radial approach, PCI of coronary lesions via radial route was associated with a relatively small but significant radiation exposure in our study. Compared to femoral access, diagnostic CA via radial access was not related to an increased radiation exposure.
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spelling pubmed-66832142019-08-19 Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study) Üreyen, Çağın Mustafa Coşansu, Kahraman Vural, Mustafa Gökhan Şahin, Sait Emir Kocayiğit, İbrahim Pabuccu, Mustafa Türker Aksoy, Muhammed Necati Murat Ağaç, Mustafa Tarık Tatlı, Ersan Gündüz, Hüseyin Akdemir, Ramazan Anatol J Cardiol Original Investigation OBJECTIVE: It is still debatable whether diagnostic coronary angiography (CA) or percutaneous coronary interventions (PCIs) increase radiation exposure when performed via radial approach as compared to femoral approach. This question was investigated in this study by comparison of dose-area product (DAP), reference air kerma (RAK), and fluoroscopy time (FT) among radial and femoral approaches. METHODS: All coronary procedures between November 2015 and November 2017 were assessed; and 4215 coronary procedures were enrolled in the study. Patients with bifurcation, chronic total occlusion, cardiogenic shock, or prior coronary artery bypass surgery were excluded. These 4215 procedures were evaluated for three different categories: diagnostic CA (Group I), PCI in patients with stable angina (Group II), and PCI in patients with ACS (Group III). RESULTS: Age was significantly higher in the femoral arm of all groups. Among patients in the radial arm of Groups I and II, males were over-represented. Therefore, a multiple linear regression analysis with stepwise method was performed. After adjusting these clinical confounders, there was no significant difference with regard to DAP, RAK, and FT between femoral and radial access in Group I. In contrast, PCI via radial access was significantly associated with increased DAP, RAK, and FT in Groups II and III. CONCLUSION: In spite of an increased experience with trans-radial approach, PCI of coronary lesions via radial route was associated with a relatively small but significant radiation exposure in our study. Compared to femoral access, diagnostic CA via radial access was not related to an increased radiation exposure. Kare Publishing 2019 2019-05-10 /pmc/articles/PMC6683214/ /pubmed/31264653 http://dx.doi.org/10.14744/AnatolJCardiol.2019.06013 Text en Copyright: © 2019 Turkish Society of Cardiology http://creativecommons.org/licenses/by-nc-sa/4.0 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Investigation
Üreyen, Çağın Mustafa
Coşansu, Kahraman
Vural, Mustafa Gökhan
Şahin, Sait Emir
Kocayiğit, İbrahim
Pabuccu, Mustafa Türker
Aksoy, Muhammed Necati Murat
Ağaç, Mustafa Tarık
Tatlı, Ersan
Gündüz, Hüseyin
Akdemir, Ramazan
Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)
title Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)
title_full Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)
title_fullStr Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)
title_full_unstemmed Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)
title_short Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study)
title_sort is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (the sakarya study)
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683214/
https://www.ncbi.nlm.nih.gov/pubmed/31264653
http://dx.doi.org/10.14744/AnatolJCardiol.2019.06013
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