Padrão de exposição radiológica e preditores de superexposição dos pacientes submetidos a procedimentos cardiológicos invasivos em equipamentos com detectores planos

Abstract

Background: Invasive cardiologic procedures expose patients and physicians to the risks of ionizing radiation. The aim of this study is to determine patterns and predictors of radiation overexposure during cardiologic procedures. Methods: Prospective cohort study to investigate patients undergoing invasive cardiologic procedures between August 2010 and January 2011 in flat detector fluoroscopy systems. Clinical, angiographic and radiation exposure characteristics were recorded in a dedicated database. Radiation exposure patterns were determined in patients undergoing coronary angiography, elective (e-PCI) and ad hoc (AH-PCI) percutaneous coronary intervention. Independent predictors of increased radiation exposure were identified by multiple logistic regression analysis. Results: The study population included 670 patients, 419 undergoing coronary angiography, 137 e-PCI and 114 AH-PCI. The mean radiation dose received by the patients was 561.

Comparison of radiological exposure of patients undergoing coronary angiography and staged or ad hoc percutaneous coronary intervention by radial access

“…However, FT alone does not ensure that a lower dose is delivered to the patient, for it does not include the sum of cine and fluoroscopic modes, which is very variable among procedures and operators. 20,21 When we analyzed the radiological exposure rates and the technical parameters of the groups, we observed statistically higher values in Group A when compared with Group B in K ap total dose, K ap fluoro, K ap cine, I ak total dose, I ak fluoro, I ak cine, total scoping time, CST, and number of projections (Table 4). In a more detailed analysis of cine images, we observed higher values, with statistical significance, in Group A when compared with Group B in the radiological rates of K ap 15f/s cine (6,240.5±3,016.5µGym 2 vs. 4,860.2±2,786.2µGym 2 ; p=0.004); 5 Table 5.…”

Padrão de Exposição Radiológica em Profissionais da Saúde Durante Procedimentos Cardiológicos Invasivos

“…The authors have previously demonstrated the current patterns of radiological exposure during diagnostic and therapeutic procedures. 1 In addition, they determined that weight, 8 type of procedure, 9,10 and the radial access route 11 are important predictors of increased radiation exposure. However, until recently, individual occupational exposure with the use of flat-panel detector devices was unknown.…”

“…As the number of invasive tests in modern cardiology increases, patients and the medical and nursing staffs are exposed to higher doses of ionizing radiation. 1,2 All images were obtained with image acquisition at a speed of 15 frames per second. The examinations were performed by qualified interventionists and exclusively via the femoral access route.…”

Impacto do peso corporal dos pacientes na exposição radiológica durante procedimentos cardiológicos invasivos

“…This group has demonstrated that flat detector equipment can add 65% more radiation compared to image intensifier devices, 22 and has also demonstrated that up to 12% of the invasive cardiac procedures surpassed the critical dose of 2 Gy. 8 Nowadays, skin lesions, which were previously rare, have been reported during interventional cardiology procedures. 5 More recently, six alarming cases of brain tumors 6 in interventional cardiology patients have again raised concerns about occupational risks.…”

“…The RADIAÇÃO registry 8 is an institutional registry aimed at documenting the diagnostic and therapeutic procedures performed with the help of flat detectors in the field of interventional cardiology. Information regarding radiation exposure and technical details of the procedures are prospectively registered.…”