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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引用次数: 0

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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操作者辐射暴露比较左桡动脉入路和均匀超内收的右桡动脉入路：HARRA研究。

背景：辐射暴露是介入心脏病专家面临的最不利的职业危害之一。在诊断性心导管插入术中，不同的动脉通路显示出不同的操作人员辐射暴露。方法：这项单中心随机对照试验评估了主手术者在使用左桡动脉（LRA）入路与均匀超内收的右桡动脉（HARRA）入路时，在4个不同解剖部位（胸、腹、左眼和右眼）的累积辐射暴露和标准化辐射暴露。患者（n=534）随机分为LRA组（n=269）和HARRA组（n=265）。诊断置管时，实时辐射剂量计分别置于每位操作者的胸、腹、左眼和右眼。结果：累积辐射测量值：胸腔(LRA, 9.66±8.57微西弗[μSv] vs HARRA， 12.27±7.09 μSv；PPPP = 0.01)。归一化辐射测量值为：胸部(LRA, 0.38±0.35 vs HARRA, 0.49±0.24；PPPP = 0.02)。LRA的锁骨下弯曲度比HARRA低（15.6%比32.5%）。结论：与HARRA相比，在诊断心导管期间，LRA对主要手术者胸部、腹部、左眼和右眼的累积和标准化辐射暴露显著减少。操作人员应考虑使用LRA比HARRA更频繁地进行心导管诊断，因为这种方法可以减少职业辐射暴露。注册：网址：https://www.clinicaltrials.gov；唯一标识符：NCT05833516。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.