{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:34:31Z","timestamp":1789446871038,"version":"build-2803163510"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Radiation exposure is one of the most adverse occupational hazards faced by interventional cardiologists. Various arterial access sites have shown to yield different operator radiation exposure during diagnostic cardiac catheterization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This single-center randomized controlled trial assessed the cumulative radiation exposure and normalized radiation exposure at 4 different anatomic locations (thorax, abdomen, left eye, and right eye) of the primary operator when using the left radial artery (LRA) approach compared with a uniform hyper-adducted right radial artery (HARRA) approach. Patients (n=534) were randomized to LRA (n=269) or HARRA (n=265). During diagnostic catheterization, real-time radiation dosimeters were placed on the thorax, abdomen, left eye, and right eye of each operator.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Cumulative radiation measurements were as follows: thorax (LRA, 9.66\u00b18.57 microsieverts [\u03bcSv] versus HARRA, 12.27\u00b17.09 \u03bcSv;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); abdomen (LRA, 27.46\u00b121.20 \u03bcSv versus HARRA, 36.56\u00b123.72 \u03bcSv;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); left eye (LRA, 2.65\u00b12.59 \u03bcSv versus HARRA, 3.77\u00b12.67 \u03bcSv;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); and right eye (LRA, 1.13\u00b11.69 \u03bcSv versus HARRA, 1.44\u00b11.62 \u03bcSv;\n              <jats:italic>P<\/jats:italic>\n              =0.01). Normalized radiation measurements were: thorax (LRA, 0.38\u00b10.35 versus HARRA, 0.49\u00b10.24;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); abdomen (LRA, 1.06\u00b10.72 versus HARRA, 1.38\u00b10.69;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); left eye (LRA, 0.10\u00b10.09 versus HARRA, 0.15\u00b10.10;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); and right eye: (LRA, 0.04\u00b10.06 versus HARRA, 0.05\u00b10.06;\n              <jats:italic>P<\/jats:italic>\n              =0.02). LRA had lower subclavian tortuosity than HARRA (15.6% versus 32.5%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The LRA was associated with significantly less cumulative and normalized radiation exposure to the thorax, abdomen, left eye, and right eye of the primary operator compared with HARRA during diagnostic cardiac catheterization. Operators should consider using LRA more frequently than HARRA for diagnostic cardiac catheterization as this approach can reduce occupational radiation exposure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT05833516.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.124.014602","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T09:00:20Z","timestamp":1742374820000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Operator Radiation Exposure Comparing the Left Radial Artery Approach and a Uniform Hyper-Adducted Right Radial Artery Approach: The HARRA Study"],"prefix":"10.1161","volume":"18","clinical-trial-number":[{"clinical-trial-number":"nct05833516","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3129-8573","authenticated-orcid":true,"given":"Richard","family":"Casazza","sequence":"first","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2030-623X","authenticated-orcid":true,"given":"Bilal","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsalan","family":"Hashmi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Fogel","sequence":"additional","affiliation":[{"name":"Department of Management, Marketing, and Entrepreneurship, Brooklyn College, Brooklyn, NY (J.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Montagna","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Frankel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot","family":"Borgen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Ayzenberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., 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J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5400-6780","authenticated-orcid":true,"given":"Jamie","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nailun","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yili","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6949-1600","authenticated-orcid":true,"given":"Habib Hymie","family":"Chera","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., 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Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Palacios","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1927-5739","authenticated-orcid":true,"given":"Chirag","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY (R.C., B.M., A.H., E.M., R.F., E.B., S.A., M.F., N.M., S.V., J.M., N.C., Y.H., C.R., H.H.C., S.R., S.C., D.G., A.P., C.A., M.V.N., 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Radiation safety for the interventional cardiologist\u2014a practical approach to protecting ourselves from the dangers of ionizing radiation. Accessed September 25 2024. https:\/\/www.acc.org\/latest-in-cardiology\/articles\/2015\/12\/31\/10\/12\/radiation-safety-for-the-interventional-cardiologist"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.018"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.06.017"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2010.07.011"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.02.012"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-302895"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.04.045"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.03.026"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.01.039"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.10.014"},{"key":"e_1_3_3_12_2","first-page":"20","article-title":"Hyper adducted right radial artery (HARRA) method to reduce radiation exposure and promote ergonomics.","volume":"28","author":"Casazza R","year":"2020","unstructured":"Casazza R, Truesdell AG. Hyper adducted right radial artery (HARRA) method to reduce radiation exposure and promote ergonomics. Cath Lab Digest. 2020;28:20\u201325. Accessed November 19, 2024. https:\/\/www.hmpgloballearningnetwork.com\/site\/cathlab\/content\/hyper-adducted-right-radial-artery-harra-method-reduce-radiation-exposure-and-promote-ergonomics","journal-title":"Cath Lab Digest"},{"key":"e_1_3_3_13_2","first-page":"28","article-title":"\u201cPeek-a-boo\u201d technique to optimize ergonomics for conventional left radial artery approach to cardiac catheterization.","volume":"28","author":"Casazza R","year":"2020","unstructured":"Casazza R. \u201cPeek-a-boo\u201d technique to optimize ergonomics for conventional left radial artery approach to cardiac catheterization. Cath Lab Digest. 2020;28:28\u2013 30. Accessed November 19, 2024. https:\/\/www.hmpgloballearningnetwork.com\/site\/cathlab\/content\/peek-boo-technique-optimize-ergonomics-conventional-left-radial-artery-approach-cardiac-catheterization","journal-title":"Cath Lab Digest"},{"key":"e_1_3_3_14_2","unstructured":"Centers for Disease Control and Prevention. Radiation and your health. 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