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Radiation exposure in complete arm, hybrid and complete femoral vascular access in patients undergoing right heart catheterization
Session:
Posters 3 - Écran 3 - Circulação / Embolia Pulmonar
Speaker:
Rita Carvalheira dos Santos
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.3 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Rita Carvalheira Dos Santos ; Luís Raposo ; Sérgio Madeira; Mariana Gonçalves; Mariana Castro; Maria José Rebocho; António Tralhão; Carlos Aguiar; Marisa Trabulo; Rui Campante Teles; Manuel Almeida; Miguel Mendes
Abstract
<p><u>AIM</u></p> <p>Right heart catheterization (RHC) is a standard procedure, namely in the workup of patients with terminal heart failure (HF) who are candidates to advanced HF therapies. Complete (arterial and venous) arm vascular access (AVA), is increasingly used in this setting. We aimed to compare procedure duration and radiation exposure for AVA (isolated and hybrid) and femoral alone vascular access (FVA).</p> <p> </p> <p><u>METHODS</u></p> <p>Single-centre retrospective analysis of 185 consecutive patients between Feb 2011 and Nov 2018 who underwent RHC. Of these, we compared a total of 171 pts (14 pts were excluded because missing data regarding venous access), that underwent RHC by complete femoral access (FVA; n=70), complete AVA (n=66) and hybrid access (HVA; n= 35) - either intentionally, due to anticipated difficulties, or access failure - concerning procedure duration and radiation exposure. Standard statistics (chi-square, T-student and Mann-Whitney tests) were used according to the tested variables.</p> <p> </p> <p><u>RESULTS</u></p> <p>Complete AVA entered our practice in 2015 and its use increased progressively, from an initial 29% to 73% of the procedures in 2018. The three groups did not differ significantly in their baseline characteristics.</p> <p>When compared to complete femoral access, complete AVA procedures exposed both the patient and the operator to significantly less fluoroscopy radiation time (8.49 IQR 6.2-12.4min vs 9.24 IQR 7.6-15.4min, p=0.002) and dose (radiation dose: 2059 IQR 1046-3717 mGy/m<sup>2</sup> vs 4246 IQR 2558-10099 mGy/m<sup>2</sup>, p<0.001; effective radiation dose: 176 IQR 96-369 mGy vs 508 IQR 297-1668 mGy). There was no difference in total procedure duration (55 IQR 45-67min vs 52 IQR 42-68min; p=0.513).</p> <p>The hybrid procedures were significantly longer than complete femoral access (70min IQR 51-9 vs 52min IQR 43-68, p=0.013) but used less effective x-ray dose (381 IQR 158-495 vs 470 IQR 277-1187, p=0.03).</p> <p> </p> <p><u>CONCLUSIONS</u></p> <p>Complete arm vascular access is associated with lower radiation exposure despite similar procedure duration.</p>
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