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)

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Objective: It is still debatable whether diagnostic coronary angiography (CA) or percutaneous coronary interventions (PCIs) increase radiationexposure when performed via radial approach as compared to femoral approach. This question was investigated in this study by comparison ofdose-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 enrolledin the study. Patients with bifurcation, chronic total occlusion, cardiogenic shock, or prior coronary artery bypass surgery were excluded. These4215 procedures were evaluated for three different categories: diagnostic CA (Group I), PCI in patients with stable angina (Group II), and PCI inpatients 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 overrepresented. 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 radialaccess 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 arelatively small but significant radiation exposure in our study. Compared to femoral access, diagnostic CA via radial access was not related toan increased radiation exposure. (Anatol J Cardiol 2019; 22: 5-12)