COMPARISON OF RADIATION AND CONTRAST SAFETY BETWEEN RADIAL AND FEMORAL APPROACHES IN PATIENTS UNDERGOING CORONARY CATHETERIZATION

Abstract

Objective: To compare radiation and contrast safety between radial and femoralapproaches in patients undergoing coronary catheterization.

Methodology: This cross sectional study was conducted at National Institute ofCardiovascular Diseases, Karachi from June 2014 to June 2015. Patients ofeither gender and any age undergoing cardiac catheterization procedures wereincluded in the study. Fluoroscopy time was measured in min and contrastamount was measured in terms of milliliter (ml). Procedures were divided in 2groups on basis of access sites [(femoral (f-CA) and radial (r-CA)]. Procedureswere performed by different operators with different level of expertise and weregrouped into three (consultants, senior registrar and post fellow trainees).Procedures were categorized into two groups depending on the nature ofprocedure (coronary angiography, elective PCI). Statistical analysis wasperformed using SPSS-20.

Results: A total of 957 patients were included in this study out of which 731 werediagnostic coronary angiograms and 226 were percutaneous coronaryintervention. Among patients in coronary angiography group, mean age was53.97+10.748 years. Mean fluoroscopic time was 4.175+4.13 min. About 671(79%) were f-CA and 70 (21%) were r-CA. Significant difference in fluoroscopytime was observed in patients who underwent r-CA as compared to the f-CAgroup (p=0.003). Mean contrast volume was 78.54+ 24.54 ml. No significantdifference was found in two groups (p=0.454). Out of 226 PCI, 163 were f-PCI(72.12%) and 63 (27.86%) were r-PCI. Mean fluoroscopic time was9.613+6.072 min. No significant difference in fluoroscopy time was observed inpatients who underwent r-CA as compared to the f-CA group (p=0.129). Meancontrast volume was 147.82 44.83 ml. No significant difference was found intwo groups (p=0.248).

Conclusion: Fluoroscopy time of patients undergoing radial angiography wassignificantly increased than femoral route. No such difference was observed forPCI. Contrast amount used was similar in two groups of patient undergoingangiography or angioplasty.