Operator radiation exposure comparing left-radial artery and right-radial artery approaches: A systematic review and meta-analysis - 30/04/26
, Arsalan Hashmi, MD a, Joshua Fogel, PhD b, Jacob Shani, MD aHighlights |
• | Operator radiation exposure (ORE) can have adverse long-term effects. |
• | First meta-analysis to compare operator radiation exposure when using LRA vs RRA. |
• | Cumulative ORE lower for the LRA than RRA at thorax, left wrist, and neck. |
• | Cumulative ORE does not differ between the LRA and RRA at the left eye. |
ABSTRACT |
Background |
The radial artery approach is the predominant access site for percutaneous coronary interventions (PCI) due to its safety profile. Most centers prefer the right-radial artery approach (RRA) due to historical laboratory configurations. However, a reduction in operator radiation exposure (ORE) has been theorized for the left-radial artery approach (LRA) due to better shielding and more favorable subclavian artery anatomy.
Objectives |
To compare ORE between the LRA and RRA during cardiac catheterization.
Methods |
We performed a meta-analysis of ORE comparing LRA and RRA. The ratio of means (ROM) was used to estimate the mean effect size.
Results |
This analysis includes 10 studies with 5,168 procedures (LRA, n = 2,410 vs RRA, n = 2,758). Cumulative ORE favored the LRA with lower levels at the thorax (ROM = 0.68, 95% CI: 0.52, 0.88, P < .001), left wrist (ROM = 0.64, 95% CI: 0.45, 0.93, P = .02), and neck (ROM = 0.68, 95% CI: 0.53, 0.86, P < .001). Cumulative ORE did not favor either the LRA or RRA at the left eye (ROM = 0.83, 95% CI: 0.63, 1.11, P = .22). Heterogeneity was high for thorax, left eye, and left wrist but not for neck. Possible publication bias was not present for thorax, left eye, and neck while left wrist had possible publication bias (Egger test: P = .02).
Conclusions |
We recommend that the LRA should be the primary access site for operators in order to reduce ORE in laboratories with standard shielding configurations.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Plan
Vol 297
Article 107385- juillet 2026 Retour au numéro
Article précédent
- Integration of a task strengthening strategy for hypertension management into HIV care in Nigeria: Baseline characteristics of participants in a cluster randomized controlled trial
- Weixi Chen, Adesola Z. Musa, Oluwatosin Odubela, Deborah Onakomaiya, Shivani Mishra, Nafesa Kanneh, Calvin L. Colvin, Yusuf Mariam, Ifeoma Idigbe, Chioma Nwankwo, Yemi Odejobi, Ayomide Adewumi, David A. Oladele, Bamidele Tayo, Angela A. Aifah, JiYuan Hu, Gbenga Ogedegbe, Juliet Iwelunmor, Oliver Ezechi
- Remote dietitian counseling with short-term meal delivery improves DASH diet adherence and lowers blood pressure in veterans with hypertension and obesity
- Namratha Atluri, Lauren Herty, Carly Runge, Joanna Wells, Margaret Scisney-Matlock, Scott L. Hummel
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?