Radiation-Induced Noncancer Risks in Interventional Cardiology: Optimisation of Procedures and Staff and Patient Dose Reduction

Sun, Zhonghua; AbAziz, Aini; Yusof, Ahmad Khairuddin Md

doi:10.1155/2013/976962

Cited by 41 publications

(38 citation statements)

References 95 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…cumulative dose dependant), and the severity of the reaction or cell injury will increase as the dose exceeds the threshold [27]. Therefore, it is very important to be aware of the radiation dose and to implement dose reduction strategies during interventional radiology procedures because radiation exposure is a significant concern for interventionalists and patients due to the increasing workloads and increasing complexity of procedures over the last decade [5,27,28].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Efficiency of Radiation Protection Training in Raising Awareness of Medical Staff Working in Catheterisation Laboratory

Alahmari¹,

Sun

2015

CMIR

Self Cite

View full text Add to dashboard Cite

The purpose of this study is to conduct a systematic review of the efficiency of radiation protection (RP) training in minimising the radiation dose to both medical staff and patients.The literature search for the relevant articles was performed using five different databases which included Scopus, ScienceDirect, PubMed, Medline and ProQuest. The search covered English language publications in the period between 2000 and 2014. The search was also limited to peer-reviewed articles on human subjects and reporting patient doses, staff doses or both before and after RP training. The dose reductions were compared using percentage calculations. Ten articles met the inclusion criteria and were included in the study. Seven of these studies showed the value of the RP training by measuring the patient dose and the fluoroscopy time (FT) pre-and post-training , whereas the remaining two of the three studies focused on the occupational doses only and one reported patient and staff doses as well as the FT. After receiving training, a reduction was found in patient doses and FT with a mean and standard deviation of 49% ± 0.15 and 12% ± 0.15, respectively. Additionally, the analysis displayed an occupational dose reduction by a mean and standard deviation of 72% ± 0.14 after receiving training. This review shows the necessity and efficacy of RP training in order to provide a safer environment when utilising the fluoroscopic image-guided machines by medical staff working in the catheterisation laboratory.

show abstract

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Efficiency of Radiation Protection Training in Raising Awareness of Medical Staff Working in Catheterisation Laboratory

Alahmari¹,

Sun

2015

CMIR

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a large US population survey, CA and percutaneous coronary intervention (PCI) were among the 20 imaging procedures that provided the largest contribution to annual cumulative radiation doses . Radiation‐induced skin injuries are a real risk in PCI with high cumulative skin doses . Both physicians and manufacturers are making efforts to implement new techniques in order to reduce the possible radiation risks, while maintaining an image quality that is sufficient for the respective clinical tasks .…”

Section: Introductionmentioning

confidence: 99%

Novel X‐ray imaging technology enables significant patient dose reduction in interventional cardiology while maintaining diagnostic image quality

Eloot

Thierens

Taeymans

et al. 2015

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives: The purpose of this study was to quantify the reduction in patient radiation dose during coronary angiography (CA) by a new X-ray technology, and to assess its impact on diagnostic image quality. Background: Recently, a novel X-ray imaging technology has become available for interventional cardiology, using advanced image processing and an optimized acquisition chain for radiation dose reduction. Methods: 70 adult patients were randomly assigned to a reference X-ray system or the novel X-ray system. Patient demographics were registered and exposure parameters were recorded for each radiation event. Clinical image quality was assessed for both patient groups. Results: With the same angiographic technique and a comparable patient population, the new imaging technology was associated with a 75% reduction in total kerma-area product (KAP) value (decrease from 47 Gycm 2 to 12 Gycm 2 , P < 0.001). Clinical image quality showed an equivalent detail and contrast for both imaging systems. On the other hand, the subjective appreciation of noise was more apparent in images of the new image processing system, acquired at lower doses, compared to the reference system. However, the higher noise content did not affect the overall image quality score, which was adequate for diagnosis in both systems. Conclusions: For the first time, we present a new X-ray imaging technology, combining advanced noise reduction algorithms and an optimized acquisition chain, which reduces patient radiation dose in CA drastically (75%), while maintaining diagnostic image quality. Use of this technology may further improve the radiation safety of cardiac angiography and interventions.

show abstract

“…The main benefit of this approach is near elimination of radiation exposure for the cardiologist and the patient without increasing the procedural risk. This is especially important since the cumulative radiation exposure of cardiologists has been associated with adverse outcomes . Reducing radiation exposure has similar benefits for patients undergoing electrophysiology procedures that require access to the left atrium .…”

Section: Discussionmentioning

confidence: 99%

“…This is especially important since the cumulative radiation exposure of cardiologists has been associated with adverse outcomes. [12][13][14] Reducing radiation exposure has similar benefits for patients undergoing electrophysiology procedures that require access to the left atrium. 15 Furthermore, the catheter laboratory team does not require lead aprons, which are associated with significant morbidity when worn for long procedures such as complex catheter ablations.…”

Section: Discussionmentioning

confidence: 99%

A novel technique for performing transseptal puncture guided by a non‐fluoroscopic 3D mapping system

Sawhney

Berndt

Watts

et al. 2018

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background Transseptal puncture (TSP) is commonly performed under fluoroscopic guidance in left atrial ablation procedures. This exposes patients and healthcare professionals to deleterious ionizing radiation. We describe a novel technique for performing TSP non‐fluoroscopically using a three‐dimensional (3D) mapping system only. The safety and efficacy of this technique is compared to traditional fluoroscopy guided TSP. Methods Retrospective, single‐center study of patients undergoing TSP for left atrial ablation. Those undergoing TSP using 3D mapping system alone (nonfluoroscopy group) were compared to those undergoing fluoroscopic guided TSP (Fluoroscopy group). Clinical, procedural data and complications were analyzed from a prospective registry. Results Twenty patients (32 TSPs) in the nonfluoroscopy (NF) group were compared to 14 patients (25 TSPs) in fluoroscopy (F) group. TSP success rates were similar across the groups (88% vs 96% in the NF and F groups, P = 0.97). In the NF group, there was one cardiac tamponade, two unsuccessful TSPs (previous cardiac surgery—required TOE guided TSP), and one patient required fluoroscopy on a background of CRTD device to avoid lead displacement. The mean fluoroscopy time and dose were significantly lower in the nonfluoroscopy group (0.75 ± 0.50 vs 5.32 ± 3.23 min, P < 0.001; 92.5 ± 60.7 vs 394.3 ± 182.7 cGy/cm2, P < 0.001). Conclusion Our study shows that TSPs can be performed safely and effectively using this non‐fluoroscopic novel technique in a select group of patients. Radiation exposure is reduced significantly without compromising patient safety. Larger studies are required to substantiate these results. Patients with cardiac implantable devices and previous cardiac surgery may pose a challenge to using this technique.

show abstract

Radiation-Induced Noncancer Risks in Interventional Cardiology: Optimisation of Procedures and Staff and Patient Dose Reduction

Cited by 41 publications

References 95 publications

A Systematic Review of the Efficiency of Radiation Protection Training in Raising Awareness of Medical Staff Working in Catheterisation Laboratory

A Systematic Review of the Efficiency of Radiation Protection Training in Raising Awareness of Medical Staff Working in Catheterisation Laboratory

Novel X‐ray imaging technology enables significant patient dose reduction in interventional cardiology while maintaining diagnostic image quality

A novel technique for performing transseptal puncture guided by a non‐fluoroscopic 3D mapping system

Contact Info

Product

Resources

About