Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography

Tarighatnia, Ali; Mohammadalian, A. H.; Ghojazade, Morteza; Pourafkari, Leili; Farajollahi, Alireza

doi:10.14744/anatoljcardiol.2017.7724

Cited by 9 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of this study showed that the projection 40º LAO/ 30º caudal had highest DAP rate values compared to other projections. This finding is in agreement with the study by Tarighatnia et al (20) who found highest patient's radiation exposure was associated with the projection 50º LAO/ 30º caudal, and it is contrary to the results of the study by Smith et al (21) who indicated the projection LAO cranial had the highest DAP rate values. The differences in the results of these studies may indicate the fact that patient's radiation exposure is more sensitive to the changes in beam angulation degree, and it reveals this reality that each center should carry out specific measurement and optimization strategy depending on its X-ray machine and physician demand.…”

Section: Discussionsupporting

confidence: 89%

Comprehensive assessment of radiation dose in patients undergoing percutaneous coronary intervention: the effect of beam angulation on patient dose optimization

et al. 2021

View full text Add to dashboard Cite

Comprehensive assessment of radiation dose inpatients undergoing percutaneous coronary intervention: the effect of beam angulation on patient dose optimization INTRODUCTIONIC procedures play an important role in the diagnosis and treatment of heart diseases. PCI is a non-surgical procedure used to open significantly narrowed or blocked coronary arteries and restore arterial blood flow to the heart tissue. Over the past few decades, the number of IC procedures has been steadily increasing for the following reasons: improvement in X-ray equipment, enhanced cardiologists' clinical skill levels, and advances in stent technologies (1)(2)(3). Nowadays, interventional cardiologists perform more complex PCI procedures which were previously impossible or required open surgery.

show abstract

Section: Discussionsupporting

confidence: 89%

Comprehensive assessment of radiation dose in patients undergoing percutaneous coronary intervention: the effect of beam angulation on patient dose optimization

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 20 Utilizing tube angles ≥ 32° increases patient dose and has also been shown to increase staff dose, especially in the LAO view. 14 Given that performing the contralateral view is associated with an increase in patient dose, operators should consider primarily using the ipsilateral view to image the right CFA, and supplement this with an LAO only if further imaging is required to visualize the bifurcation and sheath insertion point better.…”

Section: Discussionmentioning

confidence: 99%

“…11 The selected tube angle has also been demonstrated to effect both patient and staff dose. 13,14 The choice of x-ray tube angle and imaging sequences may be determined by departmental protocol, intended purpose, and operator preference. One argument for the use of higher dose acquisitions is the superior quality provided by cine or DSA as opposed to fluoroscopic imaging.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Occupational and Patient Radiation Dose and Quality Implications of Femoral Access Imaging During Coronary Angiography

Wilson‐Stewart

Fontanarosa

Malacova

et al. 2021

JMDH

View full text Add to dashboard Cite

Purpose: Cardiologists often perform angiography of the common femoral artery (CFA) access site to evaluate whether the anatomy is suitable for deployment of a vascular closure device or to assess whether iatrogenic vessel damage has occurred. The choice of acquisition mode has radiation dose implications. The objective of this study was to investigate the influence of the selected type of CFA x-ray imaging mode (fluoro save, cine acquisition and digital subtraction angiography (DSA)) and tube angle on patient and staff dose during coronary angiography. Materials and Methods: Assessment of image quality for the different modes was performed to determine whether lower dose modes provide images of sufficient clinical quality to be routinely employed. Radiation dose levels for the patients (n=782), cardiologists (n=17), scrub nurses (n=27) and scout nurses (n=32) were measured in a prospective singlecentre study between February 2017 and August 2019. Three Philips angiographic units and DoseAware dose monitoring systems were used. Results: Among the acquisition modes, fluoro save provided acceptable diagnostic quality for visualizing femoral access points and diagnosing pathology in 99% of cases. Average patient dose area product (DAP) was 83.95, 742.50, and 3363.41mGy 2 and average patient air kerma (AK) was 0.87, 8.44, and 18.61mGy for fluoro save, cine, and DSA acquisitions, respectively. The use of higher dose imaging modes, imaging in the contralateral view and utilizing steeper TA was associated with a higher patient dose. Due to staff dose being highly correlated with DAP and AK, it was difficult to observe any association between staff dose and CFA imaging mode. However, this does not discount a potential increase in occupational dose due to the use of cine angiography or digital subtraction angiography during CFA imaging. Conclusion: DSA of the CFA should be avoided during transfemoral coronary angiography unless critical to diagnostic analysis. It is recommended that fluoroscopic operators consider utilizing lower dose modes in the ipsilateral orientation ≤32° TA to reduce the risk of patient and staff radiation exposure.

show abstract

“…The use of VCD for TFA, results with procedural cost increases. Additionally, the use of these devices is not without complications [7,8].…”

mentioning

confidence: 99%

Frequency and predictors of access site complications of the transfemoral diagnostic coronary procedures

Karakuş

Arı

Acar

et al. 2020

The European Research Journal

View full text Add to dashboard Cite

Objectives: Access site complications (ASC) remain important and common adverse events after coronary angiography. The aim of this study was to evaluate the frequency and predictors of ASC in patients undergoing diagnostic coronary angiography (DCA) via the femoral artery. Methods: In this prospective analytical cross sectional study, DCA was performed in 3972 patients by transfemoral approach. The femoral access site hemostasis was obtained by manual compression in all patients. Demographic characteristics of the patients, size of the arterial sheaths, duration of compression time, patients blood pressure, medications, hemoglobin and platelet levels were recorded. All patients were evaluated for ASC (pseudoaneurysm, bleeding, dissection, hematoma). The ASC rate was calculated and ASC predictors were determined by multivariate analysis. Results: The ASC rate was 1.3% (53 of 3972 patients). The complications were more frequent in female (female: 29 of 53 [54.7%] vs male: 24 of 53 [45.3%]; p = 0.007) and chronic renal failure (CRF) patients (103 of 3919 [2.6%] vs 4 of 53 [7.5%]; p = 0.02). Hemoglobin level was lower (13.40 ± 1.73 vs 12.86 ± 1.75; p = 0.02) and manual compression time was longer (9.19 ± 3.28 min vs 14.53 ± 6.47 min; p < 0.001) in the ASC group. Clopidogrel (188 of 3919 [4.8%] vs 7 of 53 [13.2%]; p = 0.005) and low molecular weight heparin (LMWH) using were more frequent (37 of 3919 [0.9%] vs 7 of 53 [13.2%]; p < 0.001) in the ASC group.

show abstract

Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography

Cited by 9 publications

References 21 publications

Comprehensive assessment of radiation dose in patients undergoing percutaneous coronary intervention: the effect of beam angulation on patient dose optimization

Comprehensive assessment of radiation dose in patients undergoing percutaneous coronary intervention: the effect of beam angulation on patient dose optimization

Occupational and Patient Radiation Dose and Quality Implications of Femoral Access Imaging During Coronary Angiography

Frequency and predictors of access site complications of the transfemoral diagnostic coronary procedures

Contact Info

Product

Resources

About