Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach

Background: Cardiac catheterization via the trans-radial approach (TRA) has shown several advantages over the trans-femoral approach (TFA) but with a concern of higher radiation exposure. Considering the growing experience with TRA, this study compares patient's radiation during coronary angiog...

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Main Authors: Venkatesh Gurajala, Charishma Daruru, Kumar Narayanan, L. Sridhar
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Indian Heart Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S0019483225000069
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author Venkatesh Gurajala
Charishma Daruru
Kumar Narayanan
L. Sridhar
author_facet Venkatesh Gurajala
Charishma Daruru
Kumar Narayanan
L. Sridhar
author_sort Venkatesh Gurajala
collection DOAJ
description Background: Cardiac catheterization via the trans-radial approach (TRA) has shown several advantages over the trans-femoral approach (TFA) but with a concern of higher radiation exposure. Considering the growing experience with TRA, this study compares patient's radiation during coronary angiography using TRA versus TFA. Methods: This study included consecutive patients undergoing coronary angiogram over a year at tertiary hospital performed by experienced operators through radial or femoral access. Parameters compared between the two routes included fluoroscopy time (FT), cineangiography time (CT), cini-sequences (CS), and patient radiation exposure quantified by Air Kerma (AK) and Dose Area Product (DAP). Results: A total of 910 patients were studied, with 461 (50.6 %) undergoing coronary angiography (CAG) via TFA and 449 (49.4 %) via TRA. The mean age was similar between the femoral (54.07) and radial groups (53.7) years (p = 0.33), with slightly lesser proportion of males in the femoral group (74.62 % vs 79.73 %; p = 0.06). The mean (SD) DAP and AK were 15.71 (7.05) Gy·cm2 and 258.3 (99.9) mGy for the femoral group, compared to 20.76 (9.48) Gy·cm2 and 352.2 (151.5) mGy for the radial group (both p < 0.001). The mean (SD) FT, CT, and CS were 1.32 (0.94) minutes, 40.4 (9) seconds, and 5.93 (1.22) for the femoral group, compared to 2.19 (1.67) minutes, 44 (10) seconds, and 6.17 (1.26) for the radial group (all p < 0.01). Conclusion: Coronary angiography via TRA is associated with increased patient's radiation. Future studies should investigate strategies to reduce radiation exposure in trans-radial procedures.
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spelling doaj-art-4675dc0d35ec4ca3a855534cb18904872025-08-20T03:44:07ZengElsevierIndian Heart Journal0019-48322025-01-01771283510.1016/j.ihj.2025.01.005Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approachVenkatesh Gurajala0Charishma Daruru1Kumar Narayanan2L. Sridhar3Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India; Department of Cardiology, Medicover Hospitals, Hyderabad, India; Corresponding author. Department of Cardiology &amp; Electrophysiology, Medicover Hospitals, Hyderabad, Telangana, 500089, India.Department of Radiodiagnosis, Santhiram Medical College, Nandyal, IndiaDepartment of Cardiology, Medicover Hospitals, Hyderabad, IndiaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, IndiaBackground: Cardiac catheterization via the trans-radial approach (TRA) has shown several advantages over the trans-femoral approach (TFA) but with a concern of higher radiation exposure. Considering the growing experience with TRA, this study compares patient's radiation during coronary angiography using TRA versus TFA. Methods: This study included consecutive patients undergoing coronary angiogram over a year at tertiary hospital performed by experienced operators through radial or femoral access. Parameters compared between the two routes included fluoroscopy time (FT), cineangiography time (CT), cini-sequences (CS), and patient radiation exposure quantified by Air Kerma (AK) and Dose Area Product (DAP). Results: A total of 910 patients were studied, with 461 (50.6 %) undergoing coronary angiography (CAG) via TFA and 449 (49.4 %) via TRA. The mean age was similar between the femoral (54.07) and radial groups (53.7) years (p = 0.33), with slightly lesser proportion of males in the femoral group (74.62 % vs 79.73 %; p = 0.06). The mean (SD) DAP and AK were 15.71 (7.05) Gy·cm2 and 258.3 (99.9) mGy for the femoral group, compared to 20.76 (9.48) Gy·cm2 and 352.2 (151.5) mGy for the radial group (both p < 0.001). The mean (SD) FT, CT, and CS were 1.32 (0.94) minutes, 40.4 (9) seconds, and 5.93 (1.22) for the femoral group, compared to 2.19 (1.67) minutes, 44 (10) seconds, and 6.17 (1.26) for the radial group (all p < 0.01). Conclusion: Coronary angiography via TRA is associated with increased patient's radiation. Future studies should investigate strategies to reduce radiation exposure in trans-radial procedures.http://www.sciencedirect.com/science/article/pii/S0019483225000069Coronary angiographyRadial artery accessFemoral artery accessRadiation exposureFluoroscopy timeCineangiography time
spellingShingle Venkatesh Gurajala
Charishma Daruru
Kumar Narayanan
L. Sridhar
Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach
Indian Heart Journal
Coronary angiography
Radial artery access
Femoral artery access
Radiation exposure
Fluoroscopy time
Cineangiography time
title Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach
title_full Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach
title_fullStr Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach
title_full_unstemmed Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach
title_short Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach
title_sort comparison of patient radiation exposure in coronary angiography via the trans radial versus trans femoral approach
topic Coronary angiography
Radial artery access
Femoral artery access
Radiation exposure
Fluoroscopy time
Cineangiography time
url http://www.sciencedirect.com/science/article/pii/S0019483225000069
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