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Statements

Subject Item
n2:RIV%2F00216208%3A11120%2F13%3A43907361%21RIV14-MSM-11120___
rdf:type
n7:Vysledek skos:Concept
dcterms:description
Objectives The authors sought to compare the radiation dose between radial and femoral access. Background Small trials have shown an increase in the radiation dose with radial compared with femoral access, but many were performed during the operators' learning curve of radial access. Methods Patients were randomized to radial or femoral access, as a part of the RIVAL (RadIal Vs. femorAL) trial (N = 7,021). Fluoroscopy time was prospectively collected in 5740 patients and radiation dose quantified as air kerma in 1,445 patients and dose-area product (DAP) in 2,255 patients. Results Median fluoroscopy time was higher with radial versus femoral access (9.3 vs. 8.0 min, p < 0.001). Median air kerma was nominally higher with radial versus femoral access (1,046 vs. 930 mGy, respectively, p = 0.051). Median DAP was not different between radial and femoral access (52.8 Gy-cm(2) vs. 51.2 Gy.cm(2), p = 0.83). When results are stratified according to procedural volume, air kerma was increased only in the lowest tertile of radial volume centers (low 1,425 vs. 1,045 mGy, p = 0.002; middle 987 vs. 958 mGy, p = 0.597; high 652 vs. 621 mGy, p = 0.403, interaction p = 0.026). Multivariable regression showed procedural volume was the greatest independent predictor of lower air kerma dose (ratio of geometric means 0.55; 95% confidence interval 0.49 to 0.61 for highest-volume radial centers). Conclusions Radiation dose as measured by air kerma was nominally higher with radial versus femoral access, but differences were present only in lower-volume centers and operators. High-volume centers have the lowest radiation dose irrespective of which access site approach that they use. (A Trial of Transradial Versus Trans-femoral Percutaneous Coronary Intervention (PCI) Access Site Approach in Patients With Unstable Angina or Myocardial Infarction Managed With an Invasive Strategy [ RIVAL]; NCT01014273) Objectives The authors sought to compare the radiation dose between radial and femoral access. Background Small trials have shown an increase in the radiation dose with radial compared with femoral access, but many were performed during the operators' learning curve of radial access. Methods Patients were randomized to radial or femoral access, as a part of the RIVAL (RadIal Vs. femorAL) trial (N = 7,021). Fluoroscopy time was prospectively collected in 5740 patients and radiation dose quantified as air kerma in 1,445 patients and dose-area product (DAP) in 2,255 patients. Results Median fluoroscopy time was higher with radial versus femoral access (9.3 vs. 8.0 min, p < 0.001). Median air kerma was nominally higher with radial versus femoral access (1,046 vs. 930 mGy, respectively, p = 0.051). Median DAP was not different between radial and femoral access (52.8 Gy-cm(2) vs. 51.2 Gy.cm(2), p = 0.83). When results are stratified according to procedural volume, air kerma was increased only in the lowest tertile of radial volume centers (low 1,425 vs. 1,045 mGy, p = 0.002; middle 987 vs. 958 mGy, p = 0.597; high 652 vs. 621 mGy, p = 0.403, interaction p = 0.026). Multivariable regression showed procedural volume was the greatest independent predictor of lower air kerma dose (ratio of geometric means 0.55; 95% confidence interval 0.49 to 0.61 for highest-volume radial centers). Conclusions Radiation dose as measured by air kerma was nominally higher with radial versus femoral access, but differences were present only in lower-volume centers and operators. High-volume centers have the lowest radiation dose irrespective of which access site approach that they use. (A Trial of Transradial Versus Trans-femoral Percutaneous Coronary Intervention (PCI) Access Site Approach in Patients With Unstable Angina or Myocardial Infarction Managed With an Invasive Strategy [ RIVAL]; NCT01014273)
dcterms:title
Effect of Radial Versus Femoral Access on Radiation Dose and the Importance of Procedural Volume A Substudy of the Multicenter Randomized RIVAL Trial Effect of Radial Versus Femoral Access on Radiation Dose and the Importance of Procedural Volume A Substudy of the Multicenter Randomized RIVAL Trial
skos:prefLabel
Effect of Radial Versus Femoral Access on Radiation Dose and the Importance of Procedural Volume A Substudy of the Multicenter Randomized RIVAL Trial Effect of Radial Versus Femoral Access on Radiation Dose and the Importance of Procedural Volume A Substudy of the Multicenter Randomized RIVAL Trial
skos:notation
RIV/00216208:11120/13:43907361!RIV14-MSM-11120___
n7:predkladatel
n8:orjk%3A11120
n3:aktivita
n17:N
n3:aktivity
N
n3:cisloPeriodika
3
n3:dodaniDat
n9:2014
n3:domaciTvurceVysledku
n10:2228734
n3:druhVysledku
n18:J
n3:duvernostUdaju
n14:S
n3:entitaPredkladatele
n15:predkladatel
n3:idSjednocenehoVysledku
71699
n3:idVysledku
RIV/00216208:11120/13:43907361
n3:jazykVysledku
n19:eng
n3:klicovaSlova
radiation dose; radial access; percutaneous coronary intervention; femoral access
n3:klicoveSlovo
n4:radial%20access n4:percutaneous%20coronary%20intervention n4:femoral%20access n4:radiation%20dose
n3:kodStatuVydavatele
US - Spojené státy americké
n3:kontrolniKodProRIV
[6FF42895A3DB]
n3:nazevZdroje
Journal of American College of Cardiology: Cardiovascular Interventions
n3:obor
n16:FA
n3:pocetDomacichTvurcuVysledku
1
n3:pocetTvurcuVysledku
18
n3:rokUplatneniVysledku
n9:2013
n3:svazekPeriodika
6
n3:tvurceVysledku
Widimský, Petr
n3:wos
000317485300011
s:issn
1936-8798
s:numberOfPages
9
n6:doi
10.1016/j.jcin.2012.10.016
n11:organizacniJednotka
11120