Objectives: The aim of this study was to determine occupational dose levels in interventional radiology and cardiology procedures. Methods: The study covered a sample of 25 procedures and monitored occupational dose for all laboratory personnel. Each individual wore eight thermoluminescent dosemeters next to the eyes, wrists, fingers and legs during each procedure. Radiation protection shields used in each procedure were recorded. Results: The highest doses per procedure were recorded for interventionists at the left wrist (average 485 mSv, maximum 5239 mSv) and left finger (average 324 mSv, maximum 2877 mSv), whereas lower doses were recorded for the legs (average 124 mSv, maximum 1959 mSv) and the eyes (average 64 mSv, maximum 1129 mSv). Doses to the assisting nurses during the intervention were considerably lower; the highest doses were recorded at the wrists (average 26 mSv, maximum 41 mSv) and legs (average 18 mSv, maximum 22 mSv), whereas doses to the eyes were minimal (average 4 mSv, maximum 16 mSv). Occupational doses normalised to kerma area product (KAP) ranged from 11.9 to 117.3 mSv/1000 cGy cm 2 and KAP was poorly correlated to the interventionists' extremity doses. Conclusion: Calculation of the dose burden for interventionists considering the actual number of procedures performed annually revealed that dose limits for the extremities and the lenses of the eyes were not exceeded. However, there are cases in which high doses have been recorded and this can lead to exceeding the dose limits when bad practices are followed and the radiation protection tools are not properly used.

Interventional cardiology procedures result in substantial patient radiation doses due to prolonged fluoroscopy time and radiographic exposure. The procedures that are most frequently performed are coronary angiography, percutaneous coronary interventions, diagnostic electrophysiology studies and radiofrequency catheter ablation. Patient radiation dose in these procedures can be assessed either by measurements on a series of patients in real clinical practice or measurements using patient-equivalent phantoms. In this article we review the derived doses at non-pediatric patients from 72 relevant studies published during the last 22 years in international scientific literature. Published results indicate that patient radiation doses vary widely among the different interventional cardiology procedures but also among equivalent studies. Discrepancies of the derived results are patient-, procedure-, physician-, and fluoroscopic equipmentrelated. Nevertheless, interventional cardiology procedures can subject patients to considerable radiation doses. Efforts to minimize patient exposure should always be undertaken.

Background— The ideal bifurcation stenting technique is not established, and data on the hemodynamic characteristics at stented bifurcations are limited. Methods and Results— We used computational fluid dynamics analysis to assess hemodynamic parameters known affect the risk of restenosis and thrombosis at coronary bifurcations after the use of various single- and double-stenting techniques. We assessed the distributions and surface integrals of the time averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (t r ). Single main branch stenting without side branch balloon angioplasty or stenting provided the most favorable hemodynamic results (integrated values of TAWSS=4.13·10 −4 N, OSI=7.52·10 −6 m 2 , t r =5.57·10 −4 m 2 /Pa) with bifurcational area subjected to OSI values >0.25, >0.35, and >0.45 calculated as 0.36 mm 2 , 0.04 mm 2 , and 0 mm 2 , respectively. Extended bifurcation areas subjected to these OSI values were seen after T-stenting: 0.61 mm 2 , 0.18 mm 2 , and 0.02 mm 2 , respectively. Among the considered double-stenting techniques, crush stenting (integrated values of TAWSS=1.18·10 −4 N, OSI=7.75·10 −6 m 2 , t r =6.16·10 −4 m 2 /Pa) gave the most favorable results compared with T-stenting (TAWSS=0.78·10 −4 N, OSI=10.40·10 −6 m 2 , t r =6.87·10 −4 m 2 /Pa) or the culotte technique (TAWSS=1.30· 10 −4 N, OSI=9.87·10 −6 m 2 , t r =8.78·10 −4 m 2 /Pa). Conclusions— In the studied models of computer simulations, stenting of the main branch with our without balloon angioplasty of the side branch offers hemodynamic advantages over double stenting. When double stenting is considered, the crush technique with the use of a thin-strut stent may result in improved immediate hemodynamics compared with culotte or T-stenting.

Objective: To develop and implement a method for three-dimensional (3D) reconstruction of coronary arteries from conventional monoplane angiograms. Background: 3D reconstruction of conventional coronary angiograms is a promising imaging modality for both diagnostic and interventional purposes. Methods: Our method combines image enhancement, automatic edge detection, an iterative method to reconstruct the centerline of the artery and reconstruction of the diameter of the vessel by taking into consideration foreshortening effects. The X-Ray-based 3D coronary trees were compared against phantom data from a virtual arterial tree projected into two planes as well as computed tomography (CT)-based coronary artery reconstructions in patients subjected to coronary angiography. Results: Comparison against the phantom arterial tree demonstrated perfect agreement with the developed algorithm. Visual comparison against the CT-based reconstruction was performed in the 3D space, in terms of the direction angle along the centerline length of the left anterior descending and circumflex arteries relative to the main stem, and location and take-off angle of sample bifurcation branches from the main coronary arteries. Only minimal differences were detected between the two methods. Inter-and intraobserver variability of our method was low (intra-class correlation coefficients > 0.8). Conclusion: The developed method for coronary artery reconstruction from conventional angiography images provides the geometry of coronary arteries in the 3D space. '