Randomized Comparison of Radiation Exposure in Coronary Angiography Between Right Conventional and Left Distal Radial Artery Approach (DOSE)
Randomized Comparison of Radiation Exposure in Coronary Angiography Between Right Conventional and Left Distal Radial Artery Approach: The DOSE Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The left snuffbox approach is expected to be easier to perform because of less severe tortuosity of the clavicle artery. However, clinical validation of the snuffbox approach was not completed compared with the conventional radial approach. Especially, there is no clinical data on the comparison of the radiation dose in both approaches. To date, there have been some studies on the radiation dose between the left and right radial artery and femoral artery puncture site, but no studies have been conducted on the left snuffbox approach.
The purpose of this study was to compare the radiation doses of the two interventional radiologists by randomly assigning coronary angiography to the left snuffbox approach and right conventional radial approach.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Yongcheol Kim, MD
- Phone Number: +82-10-5808-4029
- Email: Dr.YongcheolKim@gmail.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients who are a palpable right radial artery and left distal radial artery
- The decision to participate voluntarily in this study and the written consent of the patient
Exclusion Criteria:
- Patients who are not palpable right radial artery and left distal radial artery
- Patients who have arteriovenous fistula
- Patients presenting with acute myocardial infarction
- Patients who need to perform coronary angiography via femoral approach, such as shock state
- Patients who have atrioventricular block on the electrocardiogram
- Patients who have a plan to perform Ergonovine provocation test
- Patients who need percutaneous coronary intervention
- Patients who are not appropriate for this study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Right conventional radial approach
After local anesthesia on right wrist area with lidocaine hydrochloride using a 26 gauge needle, the puncture is performed using a 20 gauge needle with the through-and-through puncture technique or a 21 gauge open needle with anterior wall puncture technique.
After the successful puncture, 0.025-inch straight wire or 0.018-inch hair wire are inserted, followed by insertion of the 5Fr.
radial sheath (Prelude® Radial; Merit medical, UT, USA or Radifocus® Introducer II or Glidesheath Slender®; Terumo Corporation, Tokyo, Japan).
|
We will perform coronary angiography through a Judkins 5 French diagnostic catheter and will take a basic view.
At the end of the examination, the radial sheath is removed and the right conventional radial approach is performed for about 4 hours and the left snuffbox approach for about 2 hours using the compressive bandage method.
The hemostatic device will use ez ClotRadial® (SOYEON medical Co., Ltd., Wonju, Korea).
|
|
Active Comparator: Left distal radial approach
After local anesthesia on left anatomical snuffbox area with lidocaine hydrochloride using a 26 gauge needle, the puncture is performed using a 20 gauge needle with the through-and-through puncture technique or a 21 gauge open needle with anterior wall puncture technique.
After the successful puncture, 0.025-inch straight wire or 0.018-inch hair wire are inserted, followed by insertion of the 5Fr.
radial sheath (Prelude® Radial; Merit medical, UT, USA or Radifocus® Introducer II or Glidesheath Slender®; Terumo Corporation, Tokyo, Japan).
|
We will perform coronary angiography through a Judkins 5 French diagnostic catheter and will take a basic view.
At the end of the examination, the radial sheath is removed and the right conventional radial approach is performed for about 4 hours and the left snuffbox approach for about 2 hours using the compressive bandage method.
The hemostatic device will use ez ClotRadial® (SOYEON medical Co., Ltd., Wonju, Korea).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Radiation dose of the operator (µSv)
Time Frame: Through procedure completion, up to 6 hours
|
Radiation dose (µSv) of the operator's head, hand, and body will be compared between right conventional radial artery approach and left snuffbox approach group.
|
Through procedure completion, up to 6 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Fluoroscopy time for coronary angiography (second)
Time Frame: Through procedure completion, up to 6 hours
|
Fluoroscopy time (second) will be compared between two groups during coronary angiography.
|
Through procedure completion, up to 6 hours
|
|
Dose-area product (mGy*cm2)
Time Frame: Through procedure completion, up to 6 hours
|
Dose-area product (DAP) (mGy*cm2) will be compared between two groups during coronary angiography.
|
Through procedure completion, up to 6 hours
|
|
Success rate of radial puncture (%)
Time Frame: Through procedure completion, up to 6 hours
|
Successful introduction of sheath (%)
|
Through procedure completion, up to 6 hours
|
|
Cannulation time (second)
Time Frame: Through procedure completion, up to 6 hours
|
Time from local anesthesia to sheath cannulation (second)
|
Through procedure completion, up to 6 hours
|
|
Hemostasis duration (minute)
Time Frame: During hospitalization, up to 1 month
|
Hemostasis (minute) is obtained by compressive bandage with ez ClotRadial® (SOYEON medical Co., Ltd., Wonju, Korea)
|
During hospitalization, up to 1 month
|
|
Puncture site complication after hemostasis
Time Frame: During hospitalization, up to 1 month
|
Evaluation of puncture-site bleeding complication using EASY criteria
|
During hospitalization, up to 1 month
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Yongcheol Kim, MD, Department of Cardiology, Chonnam National University Hospital
Study record dates
Study Major Dates
Study Start (Anticipated)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- DOSE
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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