Fluoroscopy-guided procedures in cardiology: is patient exposure being reduced over time?

Abstract

The number of fluoroscopy-guided procedures in cardiology is increasing over time and it is appropriate to wonder whether technological progress or change of techniques is influencing patient exposure. The aim of this study is to examine whether patient dose has been decreasing over the years. Patient dose data of more than 7700 procedures were collected from two cardiology centres. A steady increase in the patient dose over the years was observed in both the centres for the two cardiological procedures included in this study. Significant increase in dose was also observed after the installation of a flat-panel detector. The increasing use of radial access may lead to an increase in the patient exposure. The monitoring of dose data over time showed a considerable increase in the patient exposure over time. Actions have to be taken towards dose reduction in both the centres.

Pediatric patient radiation dosage during endomyocardial biopsies and right heart catheterization using a standard “ALARA” radiation reduction protocol in the modern fluoroscopic Era

“…In this study, the median air Kerma product (K) was 1.45 mGy (range, 0. [4][5][6][7][8][9][10][11][12][13][14], and the median dose area product (DAP) was 15.8 mGym2 (range, 3.5-144.5). Because this study started as a quality improvement project with the assumption that the intervention (radiation reduction) was safer for patients, there was no simultaneous control group.…”

“…Radiation “scatter” may also be a risk to staff. Because these procedures are performed repeatedly in each patient, the potential risks may be even greater to the individual pediatric heart transplant patient, especially since the risks of radiation exposure may be greater in the pediatric age group .…”

Radiation Dose Reduction in the Invasive Cardiovascular Laboratory

“…The air-kerma area product (Gycm 2 ) and related dose area product (Gycm 2 ) have been used by several investigators to describe radiation burden for adult cardiovascular procedures (7,9,(20)(21)(22)(23)(24)(25)(26). Strictly, air-kerma specifies the x-ray energy at a discrete point within the x-ray field but does not account for the influence of x-ray beam field size (area) on the total irradiation incident on the patient.…”

Reducing Patient Radiation Dosage during Pediatric SVT Ablations Using an “ALARA” Radiation Reduction Protocol in the Modern Fluoroscopic Era

“…[1][2][3][4][5] Fluoroscopy is presently the standard catheterization means of visualizing both the heart and catheters for these procedures. 6 Though efficacious for this purpose, fluoroscopy No outside sources of support for this work for any authors. No conflicts of interest for any of the authors.…”