{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:11:20Z","timestamp":1783980680939,"version":"3.55.0"},"reference-count":38,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.jcin.2025.10.028","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:50:25Z","timestamp":1761421825000},"page":"160-170","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["Radiation Exposure to Operators in Coronary Procedures Between Left Distal and Right Conventional Radial Access"],"prefix":"10.1016","volume":"19","author":[{"given":"Oh-Hyun","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Woong","family":"Roh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5568-4161","authenticated-orcid":false,"given":"Yongcheol","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok-Jae","family":"Heo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1386-349X","authenticated-orcid":false,"given":"Sang Yeub","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0342-6360","authenticated-orcid":false,"given":"Jung-Hee","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui","family":"Im","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deok-Kyu","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcin.2025.10.028_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2024.100863","article-title":"Radiation exposure, training, and safety in cardiology","volume":"3","author":"Tamirisa","year":"2024","journal-title":"JACC Adv"},{"key":"10.1016\/j.jcin.2025.10.028_bib2","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1016\/j.amjcard.2012.12.060","article-title":"Brain and neck tumors among physicians performing interventional procedures","volume":"111","author":"Roguin","year":"2013","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jcin.2025.10.028_bib3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2214\/AJR.15.15265","article-title":"Cancer risks in US radiologic technologists working with fluoroscopically guided interventional procedures, 1994-2008","volume":"206","author":"Rajaraman","year":"2016","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.jcin.2025.10.028_bib4","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/S0140-6736(08)61285-4","article-title":"Can low-dose radiation increase risk of cardiovascular disease?","volume":"372","author":"Bhatti","year":"2008","journal-title":"Lancet"},{"key":"10.1016\/j.jcin.2025.10.028_bib5","article-title":"Comprehensive shielding system enhances radiation protection for structural heart procedures","volume":"3","author":"Rizik","year":"2024","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ejvs.2022.09.005","article-title":"Editor\u2019s choice\u2014European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on radiation safety","volume":"65","author":"Modarai","year":"2023","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"10.1016\/j.jcin.2025.10.028_bib7","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejmp.2025.105096","article-title":"Radiation exposure risk for various personnel in the catheterization laboratory: a systematic review and meta-analysis","volume":"137","author":"Bal\u00e1zs","year":"2025","journal-title":"Phys Med"},{"key":"10.1016\/j.jcin.2025.10.028_bib8","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1161\/CIRCULATIONAHA.122.061527","article-title":"Effects on mortality and major bleeding of radial versus femoral artery access for coronary angiography or percutaneous coronary intervention: meta-analysis of individual patient data from 7 multicenter randomized clinical trials","volume":"146","author":"Gargiulo","year":"2022","journal-title":"Circulation"},{"key":"10.1016\/j.jcin.2025.10.028_bib9","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/S0140-6736(11)60404-2","article-title":"Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial","volume":"377","author":"Jolly","year":"2011","journal-title":"Lancet"},{"key":"10.1016\/j.jcin.2025.10.028_bib10","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1016\/S0140-6736(15)60292-6","article-title":"Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial","volume":"385","author":"Valgimigli","year":"2015","journal-title":"Lancet"},{"key":"10.1016\/j.jcin.2025.10.028_bib11","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jcin.2025.10.028_bib12","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jcin.2025.10.028_bib13","first-page":"1027","article-title":"Comparison of transradial coronary procedures via right radial versus left radial artery approach: a meta-analysis","volume":"88","author":"Shah","year":"2016","journal-title":"Catheter Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib14","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1136\/heartjnl-2012-302895","article-title":"Operator exposure to x-ray in left and right radial access during percutaneous coronary procedures: OPERA randomised study","volume":"99","author":"Dominici","year":"2013","journal-title":"Heart"},{"key":"10.1016\/j.jcin.2025.10.028_bib15","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.amjcard.2016.04.045","article-title":"Radiation exposure of the operator during coronary interventions (from the RADIO Study)","volume":"118","author":"Kallinikou","year":"2016","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jcin.2025.10.028_bib16","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.jcin.2015.03.026","article-title":"Effect of vascular access site choice on radiation exposure during coronary angiography: the REVERE trial (Randomized Evaluation of Vascular Entry Site and Radiation Exposure)","volume":"8","author":"Pancholy","year":"2015","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib17","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.ahj.2010.10.003","article-title":"Transradial approach (left vs right) and procedural times during percutaneous coronary procedures: TALENT study","volume":"161","author":"Sciahbasi","year":"2011","journal-title":"Am Heart J"},{"key":"10.1016\/j.jcin.2025.10.028_bib18","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/j.jcin.2018.01.252","article-title":"Incidence, determinants, and outcomes of left and right radial access use in patients undergoing percutaneous coronary intervention in the United Kingdom: a national perspective using the BCIS dataset","volume":"11","author":"Rashid","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib19","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.jcin.2021.02.033","article-title":"Distal radial access: consensus report of the first Korea-Europe transradial intervention meeting","volume":"14","author":"Sgueglia","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib20","doi-asserted-by":"crossref","first-page":"851","DOI":"10.4244\/EIJ-D-17-00079","article-title":"Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI)","volume":"13","author":"Kiemeneij","year":"2017","journal-title":"EuroIntervention"},{"key":"10.1016\/j.jcin.2025.10.028_bib21","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.4070\/kcj.2018.0181","article-title":"Feasibility of coronary angiography and percutaneous coronary intervention via left snuffbox approach","volume":"48","author":"Kim","year":"2018","journal-title":"Korean Circ J"},{"key":"10.1016\/j.jcin.2025.10.028_bib22","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.030774","article-title":"Distal versus proximal radial artery access for cardiac catheterization: 30-day outcomes of the DIPRA study","volume":"12","author":"Al-Azizi","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jcin.2025.10.028_bib23","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/j.jcin.2022.04.032","article-title":"Distal versus conventional radial access for coronary angiography and intervention: the DISCO RADIAL trial","volume":"15","author":"Aminian","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib24","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.jcin.2020.10.013","article-title":"Distal radial artery approach to prevent radial artery occlusion trial","volume":"14","author":"Eid-Lidt","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib25","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2023.1007147","article-title":"Comparison of spasmolytic regimen for prevention of radial artery spasm during the distal radial approach: a single-center, randomized study","volume":"10","author":"Lee","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.jcin.2025.10.028_bib26","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1016\/j.jacc.2021.09.006","article-title":"2021 ACC\/AHA\/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"79","author":"Members","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jcin.2025.10.028_bib27","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"2018 ESC\/EACTS guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jcin.2025.10.028_bib28","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1161\/CIRCINTERVENTIONS.111.961185","article-title":"Operator radiation exposure during percutaneous coronary procedures through the left or right radial approach: the TALENT dosimetric substudy","volume":"4","author":"Sciahbasi","year":"2011","journal-title":"Circ Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib29","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.recesp.2023.05.010","article-title":"Radiation protection in interventional echocardiography. Recommendations of the SEC-Cardiovascular Imaging Association\/SEC-Interventional Cardiology Association","volume":"76","author":"Cecconi","year":"2023","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"10.1016\/j.jcin.2025.10.028_bib30","first-page":"29","article-title":"Recommendations for occupational radiation protection in interventional cardiology","volume":"82","author":"Dur\u00e1n","year":"2013","journal-title":"Catheter Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0146645317750356","article-title":"ICRP Publication 139: occupational radiological protection in interventional procedures","volume":"47","author":"L\u00f3pez","year":"2018","journal-title":"Ann ICRP"},{"key":"10.1016\/j.jcin.2025.10.028_bib32","doi-asserted-by":"crossref","DOI":"10.2174\/011573403X304828240819050538","article-title":"Advancements in cardiac catheterization safety: novel radiation protection approaches redefining occupational health","volume":"21","author":"Shaghaghi","year":"2025","journal-title":"Curr Cardiol Rev"},{"key":"10.1016\/j.jcin.2025.10.028_bib33","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0277436","article-title":"Effect of an optimized X-ray blanket design on operator radiation dose in cardiac catheterization based on real-world angiography","volume":"17","author":"Davidsen","year":"2022","journal-title":"PLos One"},{"key":"10.1016\/j.jcin.2025.10.028_bib34","article-title":"The impact of the RADPAD in reducing radiation exposure in a contemporary cardiac cath lab: rationale and design of the ATTENUATE trial","author":"Medranda","year":"2025","journal-title":"Cardiovasc Revasc Med"},{"key":"10.1016\/j.jcin.2025.10.028_bib35","first-page":"1164","article-title":"A randomized study comparing the use of a pelvic lead shield during trans-radial interventions: threefold decrease in radiation to the operator but double exposure to the patient","volume":"85","author":"Musallam","year":"2015","journal-title":"Catheter Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib36","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.jcin.2013.11.026","article-title":"Operator radiation exposure and physical discomfort during a right versus left radial approach for coronary interventions: a randomized evaluation","volume":"7","author":"Kado","year":"2014","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib37","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.124.014602","article-title":"Operator radiation exposure comparing the left radial artery approach and a uniform hyper-adducted right radial artery approach: the HARRA study","volume":"18","author":"Casazza","year":"2025","journal-title":"Circ Cardiovasc Interv"},{"key":"10.1016\/j.jcin.2025.10.028_bib38","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.jcin.2021.09.037","article-title":"Distal or traditional transradial access site for coronary procedures: a single-center, randomized study","volume":"15","author":"Tsigkas","year":"2022","journal-title":"JACC Cardiovasc Interv"}],"container-title":["JACC: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1936879825026871?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1936879825026871?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T23:09:31Z","timestamp":1775516971000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1936879825026871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["S1936879825026871"],"URL":"https:\/\/doi.org\/10.1016\/j.jcin.2025.10.028","relation":{},"ISSN":["1936-8798"],"issn-type":[{"value":"1936-8798","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Radiation Exposure to Operators in Coronary Procedures Between Left Distal and Right Conventional Radial Access","name":"articletitle","label":"Article Title"},{"value":"JACC: Cardiovascular Interventions","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcin.2025.10.028","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 by the American College of Cardiology Foundation. Published by Elsevier.","name":"copyright","label":"Copyright"}]}}