{"id":"26b996d0fd87","type":"article","url":"https://hartvaat.nl/2017/05/23/stralingsblootstelling-en-vasculaire-toegang-bij-acs-rad-matrix-trial/","title":"Stralingsblootstelling en vasculaire toegang bij ACS: RAD-Matrix-trial","title_en":"Radiation Exposure and Vascular Access in Acute Coronary Syndromes: The RAD-Matrix Trial.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["stride-trial"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2017.03.018","source_url":"https://doi.org/10.1016/j.jacc.2017.03.018","authors":["Alessandro Sciahbasi","Enrico Frigoli","Alessandro Sarandrea","Martina Rothenbühler","Paolo Calabrò","Alessandro Lupi","Francesco Tomassini","Bernardo Cortese","Stefano Rigattieri","Enrico Cerrato","Dennis Zavalloni","Antonio Zingarelli","Paolo Calabria","Paolo Rubartelli","Gennaro Sardella","Matteo Tebaldi","Stephan Windecker","Peter Jüni","Dik Heg","Marco Valgimigli"],"significance":5,"published":"2017-05-23","source_date":"2017-05-23","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/coronaire-angiografie-hartkatheterisatie/","https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"The RAD-Matrix trial compared radiation exposure between radial and femoral access for PCI in ACS, addressing operator and patient safety concerns related to the increasingly preferred radial approach.","created":"2026-07-03T10:26:43Z","updated":"2026-07-03T13:26:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"RAD-Matrix-trial die stralingsblootstelling vergeleek bij radiale versus femorale toegang bij ACS. Relevant voor de stralingsveiligheid van operators en patiënten.","abstract_original":"BACKGROUND: It remains unclear whether radial access increases the risk of operator or patient radiation exposure compared to transfemoral access when performed by expert operators. OBJECTIVES: This study sought to determine whether radial access increases radiation exposure. METHODS: A total of 8,404 patients, with or without ST-segment elevation acute coronary syndrome, were randomly assigned to radial or femoral access for coronary angiography and percutaneous intervention, and collected fluoroscopy time and dose-area product (DAP). RAD-MATRIX is a radiation sub-study of the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX) trial. We anticipated that 13 or more operators, each wearing a thorax (primary endpoint), wrist, and head (secondary endpoints) lithium fluoride thermoluminescent dosimeter, and randomizing at least 13 patients per access site, were needed to establish noninferiority of radial versus femoral access. RESULTS: Among 18 operators, performing 777 procedures in 767 patients, the noninferiority primary endpoint was not achieved (p value for noninferiority = 0.843). Operator equivalent dose at the thorax (77 μSv) was significantly higher with radial than femoral access (41 μSv; p = 0.02). After normalization of operator radiation dose by fluoroscopy time or DAP, the difference remained significant. Radiation dose at wrist or head did not differ between radial and femoral access. Thorax operator dose did not differ for right radial (84 μSv) compared to left radial access (52 μSv; p = 0.15). In the overall MATRIX population, fluoroscopy time and DAP were higher with radial compared to femoral access: 10 min versus 9 min (p < 0.0001) and 65 Gy·cm2 versus 59 Gy·cm2 (p = 0.0001), respectively. CONCLUSIONS: Compared to femoral access, radial access is associated with greater operator and patient radiation exposure when performed by expert operators in current practice. Radial operators and institutions should be sensitized towards radiation risks and adopt adjunctive radioprotective measures. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX; NCT101433627)."}