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Impact of Center Ex...
Impact of Center Experience on Patient Radiation Exposure During Transradial Coronary Angiography and Percutaneous Intervention : A Patient-Level, International, Collaborative, Multi-Center Analysis
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- Simard, Trevor (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Hibbert, Benjamin (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Natarajan, Madhu K. (author)
- Division of Cardiology, Hamilton Health Sciences, Hamilton ON, Canada,Hamilton Health Sciences, Hamilton, Ontario, Canada
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- Mercuri, Mathew (author)
- Division of Cardiology, Hamilton Health Sciences, Hamilton ON, Canada; Division of Cardiology, Department of Medicine, Columbia University, New York NY, USA
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- Hetherington, Simon L. (author)
- Kettering General Hospital, Kettering, United Kingdom
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- Wright, Robert (author)
- James Cook University Hospital, Middlesbrough, United Kingdom
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- Delewi, Ronak (author)
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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- Piek, Jan J. (author)
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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- Lehmann, Ralf (author)
- Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
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- Ruzsa, Zoltán (author)
- Cardiac and Vascular Center, Semmelweis University, Budapest, Hungary
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- Lange, Helmut W. (author)
- Kardiologisch-Angiologische Praxis Herzzentrum Bremen, Bremen, Germany
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- Geijer, Håkan, 1961- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Radiology, Örebro University Hospital, Örebro, Sweden,Department of Radiology, School of Medical Sciences, Örebro University, Örebro, Sweden
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- Sandborg, Michael, 1961- (author)
- Östergötlands Läns Landsting,Linköpings universitet,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Radiofysikavdelningen US,Medicinska fakulteten,Avdelningen för radiologiska vetenskaper
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- Kansal, Vinay (author)
- Faculty of Undergraduate Medicine, University of Ottawa, Ottawa ON, Canada,Faculty of Undergraduate Medicine, University of Ottawa, Ontario, Canada
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- Bernick, Jordan (author)
- Cardiovascular Research Methods Center, Ottawa ON, Canada,Cardiovascular Research Methods Center, Ottawa, Ontario, Canada
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- Di Santo, Pietro (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Pourdjabbar, Ali (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Ramirez, F. Daniel (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Chow, Benjamin J. W. (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Chong, Aun Yeong (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Labinaz, Marino (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- Le May, Michel R. (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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- O'Brien, Edward R. (author)
- Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada
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- Wells, George A. (author)
- Cardiovascular Research Methods Center, Ottawa ON, Canada,Cardiovascular Research Methods Center, Ottawa, Ontario, Canada
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- So, Derek (author)
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa ON, Canada,University of Ottawa Heart Institute, Ottawa, Ontario, Canada dso@ottawaheart.ca
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(creator_code:org_t)
- Hoboken, USA : Wiley-Blackwell, 2016
- 2016
- English.
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In: Journal of the American Heart Association. - Hoboken, USA : Wiley-Blackwell. - 2047-9980 .- 2047-9980. ; 5:6
- Related links:
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https://doi.org/10.1...
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Background: The adoption of the transradial (TR) approach over the traditional transfemoral (TF) approach has been hampered by concerns of increased radiation exposure-a subject of considerable debate within the field. We performed a patient-level, multi-center analysis to definitively address the impact of TR access on radiation exposure.Methods and Results: Overall, 10 centers were included from 6 countries-Canada (2 centers), United Kingdom (2), Germany (2), Sweden (2), Hungary (1), and The Netherlands (1). We compared the radiation exposure of TR versus TF access using measured dose-area product (DAP). To account for local variations in equipment and exposure, standardized TR:TF DAP ratios were constructed per center with procedures separated by coronary angiography (CA) and percutaneous coronary intervention (PCI). Among 57 326 procedures, we demonstrated increased radiation exposure with the TR versus TF approach, particularly in the CA cohort across all centers (weighted-average ratios: CA, 1.15; PCI, 1.05). However, this was mitigated by increasing TR experience in the PCI cohort across all centers (r=-0.8; P=0.005). Over time, as a center transitioned to increasing TR experience (r=0.9; P=0.001), a concomitant decrease in radiation exposure occurred (r=-0.8; P=0.006). Ultimately, when a center's balance of TR to TF procedures approaches 50%, the resultant radiation exposure was equivalent.Conclusions: The TR approach is associated with a modest increase in patient radiation exposure. However, this increase is eliminated when the TR and TF approaches are used with equal frequency-a guiding principle for centers adopting the TR approach.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Coronary angiography
- dose-area product
- percutaneous coronary intervention
- radial artery catheterization
- radiation
- radiation dosing
- transfemoral
- transradial
- Cardiology
- Kardiologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Simard, Trevor
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Hibbert, Benjami ...
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Natarajan, Madhu ...
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Mercuri, Mathew
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Hetherington, Si ...
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Wright, Robert
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show more...
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Delewi, Ronak
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Piek, Jan J.
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Lehmann, Ralf
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Ruzsa, Zoltán
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Lange, Helmut W.
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Geijer, Håkan, 1 ...
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Sandborg, Michae ...
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Kansal, Vinay
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Bernick, Jordan
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Di Santo, Pietro
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Pourdjabbar, Ali
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Ramirez, F. Dani ...
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Chow, Benjamin J ...
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Chong, Aun Yeong
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Labinaz, Marino
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Le May, Michel R ...
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O'Brien, Edward ...
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Wells, George A.
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So, Derek
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of the A ...
- By the university
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Örebro University
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Linköping University