Radial Artery Injury, Radiation Exposure, Vascular Access Complication
Conditions
Keywords
Radiation, Snuffbox approach, Radial approach, Vascular access
Brief summary
Randomized comparison of radiation exposure in coronary angiography between right conventional and left distal radial artery approach
Detailed description
The left snuffbox approach is expected to be easier to perform because of less severe tortuosity of the clavicle artery. However, clinical validation of the snuffbox approach was not completed compared with the conventional radial approach. Especially, there is no clinical data on the comparison of the radiation dose in both approaches. To date, there have been some studies on the radiation dose between the left and right radial artery and femoral artery puncture site, but no studies have been conducted on the left snuffbox approach. The purpose of this study was to compare the radiation doses of the two interventional radiologists by randomly assigning coronary angiography to the left snuffbox approach and right conventional radial approach.
Interventions
PROCEDUREartery puncture and coronary angiography
We will perform coronary angiography through a Judkins 5 French diagnostic catheter and will take a basic view. At the end of the examination, the radial sheath is removed and the right conventional radial approach is performed for about 4 hours and the left snuffbox approach for about 2 hours using the compressive bandage method. The hemostatic device will use ez ClotRadial® (SOYEON medical Co., Ltd., Wonju, Korea).
Sponsors
Chonnam National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Patients will be randomized either conventional right radial approach or left distal radial approach.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who are a palpable right radial artery and left distal radial artery * The decision to participate voluntarily in this study and the written consent of the patient
Exclusion criteria
* Patients who are not palpable right radial artery and left distal radial artery * Patients who have arteriovenous fistula * Patients presenting with acute myocardial infarction * Patients who need to perform coronary angiography via femoral approach, such as shock state * Patients who have atrioventricular block on the electrocardiogram * Patients who have a plan to perform Ergonovine provocation test * Patients who need percutaneous coronary intervention * Patients who are not appropriate for this study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiation dose of the operator (µSv) | Through procedure completion, up to 6 hours | Radiation dose (µSv) of the operator's head, hand, and body will be compared between right conventional radial artery approach and left snuffbox approach group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hemostasis duration (minute) | During hospitalization, up to 1 month | Hemostasis (minute) is obtained by compressive bandage with ez ClotRadial® (SOYEON medical Co., Ltd., Wonju, Korea) |
| Fluoroscopy time for coronary angiography (second) | Through procedure completion, up to 6 hours | Fluoroscopy time (second) will be compared between two groups during coronary angiography. |
| Cannulation time (second) | Through procedure completion, up to 6 hours | Time from local anesthesia to sheath cannulation (second) |
| Success rate of radial puncture (%) | Through procedure completion, up to 6 hours | Successful introduction of sheath (%) |
| Puncture site complication after hemostasis | During hospitalization, up to 1 month | Evaluation of puncture-site bleeding complication using EASY criteria |
| Dose-area product (mGy*cm2) | Through procedure completion, up to 6 hours | Dose-area product (DAP) (mGy\*cm2) will be compared between two groups during coronary angiography. |
Contacts
Primary ContactYongcheol Kim, MD
Outcome results
None listed