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Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography [Anatol J Cardiol]
Anatol J Cardiol. 2017; 18(4): 298-303 | DOI: 10.14744/AnatolJCardiol.2017.7724  

Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography

Ali Tarighatnia1, Amirhossien Mohammadalian5, Morteza Ghojazade2, Leili Pourafkari3, Alireza Farajollahi4
1Immunology Research Center and Department of Medical Physics, Tabriz University of Medical Sciences; Tabriz-Iran; Interventional Cardiology Unit, Aalinasab Hospital; Tabriz-Iran
2Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences; Tabriz-Iran
3Cardiovascular Research Center, Tabriz University of Medical Sciences; Tabriz-Iran
4Medical Education Research Center, Tabriz University of Medical Sciences; Tabriz-Iran
5Interventional Cardiology Unit, Aalinasab Hospital; Tabriz-Iran

Objective: We aimed to compare the operator and patient radiation exposure in standard projections during elective diagnostic coronary angiography procedures via transradial (TRA) versus transfemoral (TFA) approaches.
Methods: In this analytical cross-sectional study, a total of 202 consecutive patients who were candidates for diagnostic coronary angiography were randomized to undergo the procedure via TFA or TRA approaches (101 in each group). Patients with abnormal Allen test and history of coronary artery bypass surgery, valvular heart disease, and unsuccessful coronary angiography were excluded from the study. A single operator performed all of the procedures using a single angiography system. Patient and operator radiation exposure were measured using diamentor and an electronic personal dosimeter, respectively. Each procedure comprised a standardized sequence of projections including four standard views for the left coronary system and two standard views for the right coronary system.
Results: Left anterior oblique (LAO) caudal (50/30) and right anterior oblique RAO (30) projections were associated with the highest and lowest patient radiation exposure, respectively. The operator received a significantly higher radiation exposure in the TRA approach for LAO cranial (for both left and right coronary systems) and LAO caudal (for left coronary system) projections during coronary angiography compared with the TFA approach.
Conclusion: Though a similar amount of patient radiation exposure in each projection was observed among TFA and TRA groups; LAO cranial and LAO caudal projections were associated with a significantly higher operator radiation exposure in the TRA group. These findings need to be considered when choosing the optimal arterial approach for patients scheduled for coronary angiography.

Keywords: transradial approach, transfemoral approach, radiation exposure, beam projection


Ali Tarighatnia, Amirhossien Mohammadalian, Morteza Ghojazade, Leili Pourafkari, Alireza Farajollahi. Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography. Anatol J Cardiol. 2017; 18(4): 298-303

Corresponding Author: Alireza Farajollahi, Iran


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