Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Cardiothoracic Surgery
Published in: Journal of Cardiothoracic Surgery 1/2014

Open Access 01-12-2014 | Research article

RETRACTED ARTICLE: Impact of guidewire selection and operator expertise on radiation exposure in transradial angiography

Authors: Jianmin Yang, Ningfu Wang, Xiaoshan Tong, Xianhua Ye, Liang Zhou, Guoxin Tong, Yun Shen, Shuzheng Lv

Published in: Journal of Cardiothoracic Surgery | Issue 1/2014

Login to get access

Abstract

Background

Several studies have implied that the time of radiation exposure for patients and operators during the transradial approach for coronary angiography (TRA) is associated with the use of different guidewire or catheter and operator’s finesse. This study aimed to assess the effects of non-hydrophilic or hydrophilic guidewire and operator expertise on fluoroscopy time and procedure time of TRA and further effects on the procedure safety.

Methods

A total of 1035 consecutive patients undergoing TRA were recruited prospectively and respectively divided into non-hydrophilic guidewire and hydrophilic guidewire group, or well-experienced group and less-experienced group. The primary endpoints were fluoroscopy time and procedure time. Secondary endpoints included contrast volume, cost, guidewire exchange, switchover and complications.

Results

TRA by non-hydrophilic guidewire group showed shorter fluoroscopy time and procedure time compared with hydrophilic guidewire group, similar results were found between well-experienced group and less-experienced group. Moreover, using of non-hydrophilic guidewire significantly reduced the incidence of hematoma and abnormal guidewie advancement, well-experienced group showed less dosage of contrast volume, lower incidence of radial artery spasm and frequency of guidewire exchange.

Conclusions

TRA by non-hydrophilic guidewire and well-experienced operator can decrease radiation exposure of patients and operators through reducing the fluoroscopy time and procedure time and further increase procedure safety. These will contribute to the optimization of TRA procedure and promote its widely application.
Appendix
Available only for authorised users
Literature
1.
Nathan SRS: Radial versus femoral access for percutaneous coronary intervention: implications for vascular complications and bleeding. Curr Cardiol Rep. 2012, 14: 502-509. 10.1007/s11886-012-0287-5.CrossRefPubMed
2.
Frangos Noble CDBE, Noble S: Transradial approach for coronary angiography and angioplasty: the gold standard. Rev Med Suisse. 2011, 7: 528-532.PubMed
3.
Schussler JM: Effectiveness and safety of transradial artery access for cardiac catheterization. Proc (Bayl Univ Med Cent). 2011, 24: 205-209.
4.
Rodriguez-Leor OF-NE, Carrillo X, Mauri J, Rodriguez-Leor O, Fernandez-Nofrerias E, Carrillo X, Mauri J, Oliete C, Rivas Mdel C, Bayes-Genis A: Transradial percutaneous coronary intervention in cardiogenic shock: a single-center experience. Am Heart J. 2013, 165: 280-285. 10.1016/j.ahj.2012.08.011.CrossRefPubMed
5.
Jang JS, Jin HY, Seo JS, Yang TH, Kim DK, Kim DK, Kim DI, Cho KI, Kim BH, Park YH, Je HG, Kim DS: The transradial versus the transfemoral approach for primary percutaneous coronary intervention in patients with acute myocardial infarction: a systematic review and meta-analysis. Euro Interv. 2012, 8: 501-510.
6.
Shah B, Bangalore S, Feit F, Fernandez G, Coppola J, Attubato MJ, Slater J: Radiation exposure during coronary angiography via transradial or transfemoral approaches when performed by experienced operators. Am Heart J. 2013, 165: 286-292. 10.1016/j.ahj.2012.08.016.CrossRefPubMedPubMedCentral
7.
Yuan MK, Tsai DC, Chang SC, Yuan MC, Chang SJ, Chen HW, Leu HB: The risk of cataract associated with repeated head and neck CT studies: a nationwide population-based study. Am J Roentgenol. 2013, 201: 626-630. 10.2214/AJR.12.9652.CrossRef
8.
Godino C, Maccagni D, Pavon AG, Viani G, Cappelletti A, Margonato A, Colombo A: Estimating incidence of organ cancer related to PCI radiation exposure in patients treated for acute and chronic total occlusions. J Invasive Cardiol. 2013, 25: 441-445.PubMed
9.
Borghini ALGE, Picano E, Andreassi MG: Ionizing radiation and atherosclerosis: Current knowledge and future challenges. Atherosclerosis. 2013, 230: 40-47. 10.1016/j.atherosclerosis.2013.06.010.CrossRefPubMed
10.
Andreassi MG, Cioppa A, Manfredi S, Palmieri C, Botto N, Picano E: Acute chromosomal DNA damage in humanlymphocytes after radiation exposure in invasive cardiovascular procedures. Eur Heart J. 2007, 28: 2195-2199. 10.1093/eurheartj/ehm225.CrossRefPubMed
11.
Brix G, Berton M, Nekolla E, Lechel U, Schegerer A, Süselbeck T, Fink C: Cumulative radiation exposure and cancer risk of patients with ischemic heart diseases from diagnostic and therapeutic imaging procedures. Eur J Radiol. 2013, 82: 1926-1932. 10.1016/j.ejrad.2013.07.015.CrossRefPubMed
12.
Farman MTKN, Sial JA, Saghir T, Rizvi SN, Zaman KS: Comparison of fluoroscopy time during coronary angiography and interventions by radial and femoral routes- can we decrease the fluoroscopy time with increased experience? An observational study. Anadolu Kardiyol Derg. 2011, 11: 607-612.PubMed
13.
Brasselet C, Blanpain T, Tassan-Mangina S, Deschildre A, Duval S, Vitry F, Gaillot-Petit N, Clément JP, Metz D: Comparison of operator radiation exposure with optimized radiation protection devices during coronary angiograms and ad hoc percutaneous coronary interventions by radial and femoral routes. Eur Heart J. 2008, 29: 63-70. 10.1093/eurheartj/ehm508.CrossRefPubMed
14.
Lo TSRK, Chong AY, Bhatia G, Gunning M, Nolan J: Impact of access site selection and operator expertise on radiation exposure; a controlled prospective study. Am Heart J. 2012, 164: 455-461. 10.1016/j.ahj.2012.06.011.CrossRefPubMed
15.
Barbeau GR: Radial loop and extreme vessel tortuosity in the transradial approach: advantage of hydrophilic-coated guidewires and catheters. Cardiovasc Interv. 2003, 59: 442-450.
16.
McConnell EA: Performing Allen’s test. Nursing. 1997, 27: 26-
17.
Varenne O, Jégou A, Cohen R, Empana JP, Salengro E, Ohanessian A, Gaultier C, Allouch P, Walspurger S, Margot O, El Hallack A, Jouven X, Weber S, Spaulding C: Prevention of arterial spasm during percutaneous coronary interventions through radial artery: the SPASM study. Catheter Cardiovasc Interv. 2006, 68: 231-235. 10.1002/ccd.20812.CrossRefPubMed
18.
Dominici M, Diletti R, Milici C, Bock C, Placanica A, D'Alessandro G, Arrivi A, Italiani M, Buono E, Boschetti E: Operator exposure to x-ray in left and right radial access during percutaneous coronary procedures: OPERA randomised study. Heart. 2013, 99: 480-484. 10.1136/heartjnl-2012-302895.CrossRefPubMed
19.
Zhao Y, Ru L, Li J: Application of PTCA guidewire in abnormal assess of Transradial Coronary Procedures. Hebei Med J. 2011, 33: 2934-2935.
20.
Sciahbasi A, Romagnoli E, Trani C, Burzotta F, Pendenza G, Tommasino A, Leone AM, Niccoli G, Porto I, Penco M: Evaluation of the “learning curve” for left and right radial approach during percutaneous coronary procedures. Am J Cardiol. 2011, 108: 185-188. 10.1016/j.amjcard.2011.03.022.CrossRefPubMed
21.
Kristić ILJ: Radial artery spasm during transradial coronary procedures. J Invasive Cardiol. 2011, 23: 527-531.PubMed
22.
Kiemeneij FFD, Slagboom T, Laarman G, van der Wieken R: Hydrophilic coating aids radial sheath withdrawal and reduces patient discomfort following transradial coronary intervention: a randomized double-blind comparison of coated and uncoated sheaths. Catheter Cardiovasc Interv. 2003, 59: 161-164. 10.1002/ccd.10444.CrossRefPubMed
23.
Jia DA, Zhou YJ, Shi DM, Liu YY, Wang JL, Liu XL, Wang ZJ, Yang SW, Ge HL, Hu B, Yan ZX, Chen Y, Gao F, Jia DA, Zhou YJ, Shi DM, Liu YY, Wang JL, Liu XL, Wang ZJ, Yang SW, Ge HL, Hu B, Yan ZX, Chen Y, Gao F: Incidence and predictors of radial artery spasm during transradial coronary angiography and intervention. Chin Med J. 2010, 123: 843-847.PubMed
24.
Chen CWLC, Lin TK, Lin CD: A simple and effective regimen for prevention of radial artery spasm during coronary catheterization. Cardiology. 2006, 105: 43-47. 10.1159/000089246.CrossRefPubMed
25.
Coppola J, Patel T, Kwan T, Sanghvi K, Srivastava S, Shah S, Staniloae C: Nitroglycerin, nitroprusside, or both, in preventing radial artery spasm during transradial artery catheterization. J Invasive Cardiol. 2006, 18: 155-158.PubMed
26.
Goldsmit A, Kiemeneij F, Gilchrist IC, Kantor P, Kedev S, Kwan T, Dharma S, Valdivieso L, Wenstemberg B, Patel T: Radial artery spasm associated with transradial cardiovascular procedures: Results from the RAS registry. Catheter Cardiovasc Interv. 2014, 83: E32-E36. 10.1002/ccd.25082.CrossRefPubMed
27.
Koga S, Ikeda S, Futagawa K, Sonoda K, Yoshitake T, Miyahara Y, Kohno S: The use of a hydrophilic-coated catheter during transradial cardiac catheterization is associated with a low incidence of radial artery spasm. Int J Cardiol. 2004, 96: 255-258. 10.1016/j.ijcard.2003.07.016.CrossRefPubMed
28.
Sciahbasi A, Romagnoli E, Burzotta F, Trani C, Sarandrea A, Summaria F: Transradial approach (left vs right) and procedural times during percutaneous coronary procedures: TALENT study. Am Heart J. 2011, 161: 172-179. 10.1016/j.ahj.2010.10.003.CrossRefPubMed
29.
Kawashima O, Endoh N, Terashima M, Ito Y, Abe S, Ootomo T, Ogata K, Honda H, Takizawa K, Miyazaki Y, Sugawara D, Komatsu M, Sawazi Y, Ozaki T, Uchimuro T, Meguro T, Isoyama S: Effectiveness of right or left radial approach for coronary angiography. Catheter Cardiovasc Interv. 2004, 61: 333-337. 10.1002/ccd.10769.CrossRefPubMed
30.
Hamon M, Gomes S, Clergeau MR, Fradin S, Morello R, Hamon M: Risk of acute brain injury related to cerebral microembolism during cardiac catheterization performed by right upper limb arterial access. Stroke. 2007, 38: 2176-2179. 10.1161/STROKEAHA.107.482414.CrossRefPubMed
31.
Pelliccia F, Trani C, Biondi-Zoccai GG, Nazzaro M: Comparison of the feasibility and effectiveness of transradial coronary angiography Via right versus left radial artery approaches (from the PREVAIL study). Am J Cardiol. 2012, 110: 771-775. 10.1016/j.amjcard.2012.05.005.CrossRefPubMed
32.
Rao SV, Cohen MG, Kandzari DE, Bertrand OF, Gilchrist IC: The transradial approach to percutaneous coronary intervention: historical perspective, current concepts, and future directions. J Am Coll Cardiol. 2010, 55: 2187-2195. 10.1016/j.jacc.2010.01.039.CrossRefPubMed
Metadata
Title
RETRACTED ARTICLE: Impact of guidewire selection and operator expertise on radiation exposure in transradial angiography
Authors
Jianmin Yang
Ningfu Wang
Xiaoshan Tong
Xianhua Ye
Liang Zhou
Guoxin Tong
Yun Shen
Shuzheng Lv
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2014
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-014-0194-5

Other articles of this Issue 1/2014

Journal of Cardiothoracic Surgery 1/2014 Go to the issue

Research article

Association between older age and outcome after cardiac surgery: a population-based cohort study

Case report

The rupture of atrioventricular groove after mitral valve replacement in an elderly patient

Research article

Left ventricular support adjustment to aortic valve opening with analysis of exercise capacity

Case report

Single-port thoracoscopic rib resection: a case report

Research article

The effects of a low international normalized ratio on thromboembolic and bleeding complications in patients with mechanical mitral valve replacement

Research article

Recurrence after thymoma resection according to the extent of the resection