Effectiveness of Low Rate Fluoroscopy at Reducing Operator and Patient Radiation Dose During Transradial Coronary Angiography and Interventions
| Autor: | Gérald Barbeau, Goran Rimac, Rosaire Mongrain, Jean-Pierre Déry, Ricardo Allende, Eric Larose, Jean Arsenault, Robert De Larochellière, Can M. Nguyen, Olivier Costerousse, Jimmy MacHaalany, Henrique Barbosa Ribeiro, Eltigani Abdelaal, Guillaume Plourde, Olivier F. Bertrand |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Coronary angiography Cardiac Catheterization medicine.medical_specialty Time Factors animal structures medicine.medical_treatment Coronary Angiography Radiation Dosage Radiography Interventional Radiation Protection Radiation Monitoring Risk Factors Occupational Exposure Humans Medicine Fluoroscopy Dosimetry Radiation Injuries Aged Cardiac catheterization Dosimeter dosimetry medicine.diagnostic_test business.industry percutaneous coronary intervention Radiation dose Quebec imaging transradial Percutaneous coronary intervention Dose-Response Relationship Radiation Middle Aged Occupational Injuries radiation Radial Artery Conventional PCI embryonic structures Cineangiography Radiology business Nuclear medicine Cardiology and Cardiovascular Medicine |
| Zdroj: | JACC: Cardiovascular Interventions. 7(5):567-574 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2014.02.005 |
| Popis: | ObjectivesThis study sought to determine the efficacy of low rate fluoroscopy at 7.5 frames/s (FPS) versus conventional 15 FPS for reduction of operator and patient radiation dose during diagnostic coronary angiography (DCA) and percutaneous coronary intervention (PCI) via the transradial approach (TRA).BackgroundTRA for cardiac catheterization is potentially associated with increased radiation exposure. Low rate fluoroscopy has the potential to reduce radiation exposure.MethodsPatients undergoing TRA diagnostic angiography ± ad-hoc PCI were randomized to fluoroscopy at 7.5 FPS versus 15 FPS prior to the procedure. Both 7.5 and 15 FPS fluoroscopy protocols were configured with a fixed dose per pulse of 40 nGy. Primary endpoints were operator radiation dose (measured with dosimeter attached to the left side of the thyroid shield in μSievert [μSv]), patient radiation dose (expressed as dose-area product in Gy·cm2), and fluoroscopy time.ResultsFrom October 1, 2012 to August 30, 2013, from a total of 363 patients, 184 underwent DCA and 179 underwent PCI. Overall, fluoroscopy at 7.5 FPS compared with 15 FPS was associated with a significant reduction in operator dose (30% relative reduction [RR], p < 0.0001); and in patient's dose-area product (19% RR; p = 0.022). When stratified by procedure type, 7.5 FPS compared with 15 FPS was associated with significant reduction in operator dose during both DCA (40% RR; p < 0.0001) and PCI (28% RR; p = 0.0011). Fluoroscopy at 7.5 FPS, compared with 15 FPS, was also associated with substantial reduction in patients' dose-area product during DCA (26% RR; p = 0.0018) and during PCI (19% RR; p = 0.13). Fluoroscopy time was similar in 7.5 FPS and 15 FPS groups for DCA (3.4 ± 2.0 min vs. 4.0 ± 4.7 min; p = 0.42) and PCI (11.9 ± 8.4 min vs. 13.3 ± 9.7 min; p = 0.57), respectively.ConclusionsFluoroscopy at 7.5 FPS, compared with 15 FPS, is a simple and effective method in reducing operator and patient radiation dose during TRA DCA and PCI. |
| Databáze: | OpenAIRE |
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