Choosing left radial access in the Cath lab helps cardiologists limit radiation exposure
Choosing left radial access in the Cath lab helps cardiologists limit radiation exposure .
The HARRA Study,” Circulation: Cardiovascular Interventions, March 2025.
1. Study Objective: A randomized controlled trial compared radiation exposure to interventional cardiologists using the left radial artery (LRA) approach versus the hyper-adducted right radial artery (HARRA) approach during cardiac catheterization procedures.
2. Methodology: Real-time radiation dosimeters were placed on the thorax, abdomen, and both eyes of operators during 534 diagnostic catheterization procedures, randomized to either LRA or HARRA approaches.
3. Findings: The LRA approach resulted in significantly lower cumulative radiation exposure compared to the HARRA approach:
• Thorax: 9.6 μSv (LRA) vs. 12.27 μSv (HARRA)
• Abdomen: 27.46 μSv (LRA) vs. 36.56 μSv (HARRA)
• Left eye: 2.65 μSv (LRA) vs. 3.77 μSv (HARRA)
• Right eye: 1.13 μSv (LRA) vs. 1.44 μSv (HARRA)
4. Subclavian Tortuosity: The LRA approach was associated with a lower incidence of subclavian tortuosity (15.6%) compared to the HARRA approach (32.5%).
5. Clinical Implications: The study suggests adopting the LRA as the primary access site for cardiac catheterization to reduce occupational radiation exposure for interventional cardiologists. Proper setup can address ergonomic concerns associated with the LRA approach.
6. Anatomical Considerations: Patient anatomy, particularly subclavian tortuosity, plays a role in radiation exposure, with the LRA approach offering more favorable conditions.
7. Future Research: Further studies are needed to explore factors such as operator experience and their impact on radiation exposure levels.