Factors affecting exposure parameters during diagnostic coronary catheterization

Introduction Diagnostic cardiac catheterization represents an important source of radiation. Although transradial access (TRA) is being increasingly used in interventional cardiology, there are concerns about a possible increase in radiation exposure as compared to transfemoral access (TFA). Purpose The aim of this study is the comparison of radiation exposure parameters between coronary angiography procedures performed via left radial artery, right radial artery or femoral artery and the detection of factors that contribute to increased radiation dose. Materials and methods We analyzed collected data on radiation exposure for a total of 1165 consecutive diagnostic coronary angiographies excluded those concerning patients with aortocoronary bypass grafts. Dose area product (DAP) and fluoroscopy time (FT) were used as a means of radiation exposure measurement. Results The mean patients’ age was 66 ± 11 years and BMI 28.4 ± 4.6 kg/m 2 . Femoral access was used in 36.7% of the procedures, right radial access (RRA) in 50% and left radial access (LRA) in 13.3%. TRA was associated with increased FT (4.6 ± 3.3 vs 3.0 ± 2.5 min, p 2 , p  = 0.001). There were no differences regarding FT and DAP between RRA and LRA. Hypertension, the presence of ascending aorta aneurysm and the presence of coronary artery disease were predictors of increased exposure parameters, whereas diabetes mellitus was predictor of increased DAP. Conclusion TRA is associated with increased exposure parameters as compared to TFA, but there are no differences between RRA and LRA. Hypertension, ascending aorta aneurysm and coronary artery disease are adversely affecting exposure parameters.