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Left Radial Access May Lessen Radiation Exposure to Operators
Compared with right radial access, left radial access was associated with a lower radiation dose absorbed by the operator during coronary angiography, results from the OPERA study indicated.
In the randomized, prospective, double-arm OPERA study, investigators evaluated the dose of radiation absorbed by operators using either left radial access (LRA) or right radial access (RRA). The study was conducted at a university hospital and enrolled 413 patients with stable or unstable angina and silent ischemia.
There were 209 patients randomly assigned to undergo diagnostic procedures with RRA and 204 with LRA. Besides the standard dosimeter, two additional dosimeters were placed, one used only for procedures performed by RRA (right-radial dosimeter) and the other only for LRA
(left-radial dosimeter), which was positioned after patient randomization on the left side of the operator’s neck. Following PCI after coronary angiography, the neck dosimeter was removed and dose-area product (DAP) was recorded.
Researchers reported that the operator’s radiation exposure was significantly lower in the left radial group (LRA, 33 ± 37 mcSv vs. RRA, 44 ± 32 mcSv; P=.04), but found no significant differences in fluoroscopy time (LRA, 349 ± 231 seconds vs. RRA, 370 ± 246 seconds; P=.09), DAP (LRA, 7,011.42 ± 3,617.30 mcGym2 vs. RRA, 7,382.38 ± 5,226.61 mcGym2; P=.80) or contrast medium delivered (LRA, 89.92 ± 32.55 mL vs. RRA, 88.88 ± 35.35 mL; P=.45).
Roberto Diletti
“Our results suggest that the concern about an increased operators’ radiation exposure using left radial approach is unfounded,” Roberto Diletti, MD, trial investigator with Thoraxcenter, Erasmus Medical Center in Rotterdam, the Netherlands, told Cardiology Today’s Intervention. “Interestingly, an important reduction in radiation exposure associated with left radial approach was observed in both experienced and inexperienced operators. Such observation may suggest that left radial approach could be additionally favorable for inexperienced operators and could be used as the first radial option in centers that are beginning to use the radial approach for coronary catheterization.”
Disclosure: The researchers report no relevant financial disclosures.