Skip to main content
Journal cover image

Effect of Vascular Access Site Choice on Radiation Exposure During Coronary Angiography: The REVERE Trial (Randomized Evaluation of Vascular Entry Site and Radiation Exposure).

Publication ,  Journal Article
Pancholy, SB; Joshi, P; Shah, S; Rao, SV; Bertrand, OF; Patel, TM
Published in: JACC Cardiovasc Interv
August 17, 2015

OBJECTIVES: This study sought to perform a randomized noninferiority trial of radiation exposure during cardiac catheterization comparing femoral access (FA) with left radial access (LRA) and right radial access (RRA). BACKGROUND: Increased radiation exposure with radial approach compared with femoral approach remains a controversial issue. METHODS: This study randomized 1,493 patients undergoing cardiac catheterization at a tertiary care center to FA, LRA, and RRA in a 1:1:1 fashion. The primary endpoint was air kerma. The secondary endpoints included dose-area product, fluoroscopy time and operator dose per procedure, number of cineangiograms, and number of catheters. RESULTS: Baseline and procedural characteristics were similar among groups. No significant differences were observed in air kerma (medians: FA: 421 mGy [interquartile range (IQR): 337 to 574 mGy], LRA: 454 mGy [IQR: 331 to 643 mGy], and RRA: 483 mGy [IQR: 382 to 592 mGy], p = 0.146), dose-area product (medians: FA: 25.5 Gy cm(2) [IQR: 19.6 to 34.5 Gy cm(2)], LRA: 26.6 Gy cm(2) [IQR: 19.5 to 37.5 Gy cm(2)], and RRA: 27.7 Gy cm(2) [IQR: 21.9 to 34.4 Gy cm(2)], p = 0.40), or fluoroscopy time (medians: FA: 1.3 min [IQR: 1.0 to 1.7 min], LRA: 1.3 min [IQR: 1.0 to 1.7 min], and RRA: 1.32 min [IQR: 1.0 to 1.7 min], p = 0.19) among the 3 access sites. Median operator exposure was higher in the LRA group (3 mrem [IQR: 2 to 5 mrem], p = 0.001 vs. FA, and p = 0.0001 vs. RRA) compared with the FA (2 mrem [IQR: 2 to 4 mrem] and RRA groups (3 mrem [IQR: 2 to 5 mrem]). CONCLUSIONS: Radiation exposure to patients was similar during diagnostic coronary angiography with FA, RRA, and LRA. However, LRA was associated with significantly higher operator radiation exposure than were FA and RRA procedures. (Randomized Evaluation of Vascular Entry Site and Radiation Exposure [REVERE]; NCT01677481).

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

August 17, 2015

Volume

8

Issue

9

Start / End Page

1189 / 1196

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Radiation Exposure
  • Radiation Dosage
  • Radial Artery
  • Punctures
  • Occupational Exposure
  • Middle Aged
  • Male
  • India
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pancholy, S. B., Joshi, P., Shah, S., Rao, S. V., Bertrand, O. F., & Patel, T. M. (2015). Effect of Vascular Access Site Choice on Radiation Exposure During Coronary Angiography: The REVERE Trial (Randomized Evaluation of Vascular Entry Site and Radiation Exposure). JACC Cardiovasc Interv, 8(9), 1189–1196. https://doi.org/10.1016/j.jcin.2015.03.026
Pancholy, Samir B., Pankaj Joshi, Sanjay Shah, Sunil V. Rao, Olivier F. Bertrand, and Tejas M. Patel. “Effect of Vascular Access Site Choice on Radiation Exposure During Coronary Angiography: The REVERE Trial (Randomized Evaluation of Vascular Entry Site and Radiation Exposure).JACC Cardiovasc Interv 8, no. 9 (August 17, 2015): 1189–96. https://doi.org/10.1016/j.jcin.2015.03.026.
Pancholy, Samir B., et al. “Effect of Vascular Access Site Choice on Radiation Exposure During Coronary Angiography: The REVERE Trial (Randomized Evaluation of Vascular Entry Site and Radiation Exposure).JACC Cardiovasc Interv, vol. 8, no. 9, Aug. 2015, pp. 1189–96. Pubmed, doi:10.1016/j.jcin.2015.03.026.
Journal cover image

Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

August 17, 2015

Volume

8

Issue

9

Start / End Page

1189 / 1196

Location

United States

Related Subject Headings

  • Tertiary Care Centers
  • Radiation Exposure
  • Radiation Dosage
  • Radial Artery
  • Punctures
  • Occupational Exposure
  • Middle Aged
  • Male
  • India
  • Humans