Radiation Exposure
Conditions
Keywords
prospective, randomized, radiation dose, operator exposure, cardiac catheterization
Brief summary
Several studies have shown that operator exposure via left transradial catheterization has yielded less operator exposure compared to standard right transradial procedure. However, in light of new data, the investigators hypothesize a hyperadducted right arm during right transradial cardiac catheterization will yield comparable, or the same operator radiation exposure.
Detailed description
Few studies have examined operator's radiation exposure tor transradial cardiac catheterization between the left vs right radial artery approach. In light of recent studies (Schiabasi et al) demonstrating adduction of the right arm yields lower operator exposure than that of the right arm positioned away from the body to the operators. The investigators seek to examine if hyper adduction of the right arm yields similar operator exposure to that of the left radial approach. Historically the left radial approach has been more favorable in terms of operator exposure. However, the primary access site for interventional cardiologists has been the right radial artery due to cardiac catheterization laboratories set up for operators to work on the right side of the table. This study seeks to find if a hyperadducted right arm yields less, more, or similar radiation exposure to the operator in cardiac catheterization laboratory than the left radial artery approach. This study's primary outcome is to measure the radiation exposure to the primary operator during diagnostic cardiac catheterization at four different anatomical locations (these are Maimonides Medical Center employees -attending physicians in the catheterization lab). Study's secondary outcomes aim to measure Dose Area Product, mGy of radiation dose, & contrast administration to the patients undergoing the procedure and presence/absence of subclavian artery tortuosity which are recorded automatically and regardless during the diagnostic procedure.
Interventions
DIAGNOSTIC_TESTCardiac Catheterization
The cardiac catheterization is an invasive procedure in which right or left radial artery of patient will be accessed to obtain cardiac angiogram. The study participants are both operators and patients by obtaining the amount of radiation they both were exposed in these two different arm techniques. The patient will have to do nothing more than following the existing standard protocols which are followed nationwide. As, the radiation exposure to patients are already measured in the software itself. The operators however would be wearing radiation badges in 4 different anatomic locations to record radiation data for study.
Sponsors
Maimonides Medical Center
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* All the Cardiac catheterization laboratory physician operators who consent to participate in the study * Patients of any sex and gender. * Age \> 18 years old. * Patients undergoing diagnostic coronary angiogram from in-patient and out-patient settings
Exclusion criteria
* History of prior CABG (Coronary Artery Bypass Surgery). CABG patients will be excluded due to inherent increased fluoroscopic time (finding grafts). * Patients undergoing elective PCI (Percutaneous Coronary Intervention)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Operator radiation exposure | During Cardiac Catheterization | The primary operators will wear real time radiation dose monitoring at the left eye, right eye, thorax and abdomen level. At the end of each diagnostic procedure the cumulative radiation dose (measured in µSv) data at each level will be collected |
| Normalized Dose | During Cardiac Catheterization | The second primary endpoint is Normalized dose, measured by dividing cumulative dose by dose area product (CD/DAP) and entered into query sheet then logged into an Excel spreadsheet. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dose Area product (DAP) | During Cardiac Catheterization | Dose area product (DAP) is a quantity used in assessing the radiation risk from diagnostic X-ray examinations and interventional procedures. It is defined as the absorbed dose multiplied by the area irradiated, expressed in gray-centimetres squared. |
| Flouroscopy time | During Cardiac Catheterization | Duration of flouroscopy also known as duration of radiation |
| mGy | During Cardiac Catheterization | mGy is the unit of absorbed radiation dose |
| Subclavian tortuosity (Yes/no) | During Cardiac Catheterization | The anatomic complexity in subclavian artery which causes difficulty in performing cardiac catheterization through radial access. |
Countries
United States
Outcome results
None listed