Radiation Risk and Exposure of Radiologists and Patients during Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (PTCA)

Karppinen, Jaro; Parviainen, T.; Servomaa, A; Komppa, T

doi:10.1093/oxfordjournals.rpd.a082586

Cited by 50 publications

(7 citation statements)

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“…The number of interventional procedures is rapidly increasing [20], and the radiation risk to the population and to single patients is growing from both the stochastic and the deterministic points of view. FT and the total number of frames recorded are the major factors related to patient and personnel irradiation during PTCA [21][22][23][24]. In this study, the problem of complexity was measured in terms of irradiation parameters: FT required for every single procedure, total cine frames recorded, and total DAP.…”

Section: Discussionmentioning

confidence: 99%

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

Bernardi

Padovani

Morocutti

et al. 2000

Cathet. Cardiovasc. Intervent.

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Few data are available on the quantitative assessment of complexity (C), especially in relation to a patient's exposure to radiation. The relationship between several clinical (CFs), anatomic (AFs), and technical factors (TFs) versus fluoroscopy time (FT) was evaluated in 402 random percutaneous transluminal coronary angioplasty (PTCA) procedures. CFs were age, sex, single or multivessel disease, ejection fraction, and previous coronary artery bypass graft. AFs were assessed based on the American Heart Association / American College of Cardiology classification. TFs were multivessel PTCA, use of the double wire or double balloon technique, stenting, ostial stenting, bifurcation stenting, and intravascular ultrasonography. No CFs significantly influenced FT, whereas all AFs and TFs (except multivessel PTCA) did significantly influence FT. A scoring system was developed, and two complexity indexes (CI) were conceived, based on which the procedures were divided into three groups: simple, medium, and complex. The mean FTs were 471+/-289, 805+/-532, and 1,190+/-641 (P <0.0001), respectively. Total cine frame recordings were 1,119+/-572, 1,265+/-644 (P = 0.0355), and 1,418+/-785 (P<0.0001 vs. simple; P = NS vs. medium). The dose/area product measurement was 65.8+/-41.4, 93 +/-58.5 (P<0.0001), and 116.7+/-72.8 (P<0.0001 vs. simple; P = 0.00159 vs. medium), respectively. In our series, CI was directly related to AF and TF, but not to CF. Comparison of PTCA procedures and definition of appropriate FT should consider CIs.

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Section: Discussionmentioning

confidence: 99%

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

Bernardi

Padovani

Morocutti

et al. 2000

Cathet. Cardiovasc. Intervent.

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“…Recent publications show an increasing number of skin injuries during cardiac, abdominal, and neurological interventions. [2][3][4][5][6][7][8][9][10][11][12][13][14] High entrance-dose values cannot be avoided in complex investigations, because they often require long exposure times. Our method allows for skin dose management and makes it possible to keep the dose at a certain skin area as low as reasonable for the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…1 Numerous incidents of radiation-induced skin injuries have recently been reported. [2][3][4][5][6][7][8][9][10][11][12][13][14] Doses from the prolonged use of fluoroscopy can be very high and place the skin at risk for injury. Even though some modern x-ray equipment uses dose-saving measures, such as added filtration and dose-reducing variable-pulsed fluoroscopy, complicated procedures can still result in high-risk skin doses.…”

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confidence: 99%

Real-Time Quantification and Display of Skin Radiation During Coronary Angiography and Intervention

et al. 2001

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“…Personnel monitoring is also needed to fulfil the regulatory requirements for a good radiation practice. Thermoluminescent dosimetry (TLD) is the most widely used technology for personnel monitoring dosimetry [11][12][13]. A well designed, not too aged and maintained x-ray equipment coupled with the use of appropriate exposure parameters by trained operators can significantly minimize unnecessary radiation exposure to patients with no loss in image quality.…”

Section: Introductionmentioning

confidence: 99%

Risk Assessment of Occupational Exposure of Workers Engaged in Radiation Practice without Monitoring Devices

Bidemi¹,

Daniel²,

Biodun³

2019

JAMMR

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Objective: This study was carried out to evaluate occupational dose of personnel, engaged in radiation work without wearing monitoring device, at five diagnostic centres in Abeokuta, Ogun State metropolis, namely, Rainbow, New image, Bethel, Akinolugbade and Abiolad. Materials and Methods: Thermoluminescent dosimeters (TLDs) obtained from Radiation Protection Services, Lagos State University (LASU), Ojo were used for dose measurements. LASU is accredited by the Nigerian Nuclear Regulatory Authority (NNRA) to provide radiation monitoring services. The TLDs were distributed to each of the centre for personnel and area (control and supervised) monitoring. The period of exposure of the TLDs was three months. The exposed TLDs were returned to LASU for processing. The effective dose received by personnel per quarter was extrapolated to annual effective dose to make comparison with the International Commission on Radiation Protection (ICRP) recommended dose limit. The stochastic effect of the measured dose was also estimated. Results: Annual effective dose received by all personnel ranged from 1.16 - 2.54 mSv. While the highest value was obtained by personnel at Bethel diagnostic centre, the lowest value was obtained at Akinolugbade. The risk of cancer associated with these values, estimated for a million population, was 112 and 61 at Bethel and Akinolugbade respectively. Conclusion: This study showed that the annual effective doses to personnel at these centres were below the ICRP recommended dose of 20 mSv per annum. However, the Managements of these diagnostic centres should provide monitoring devices for their radiation workers in line with NNRA authorization requirements.

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Radiation Risk and Exposure of Radiologists and Patients during Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (PTCA)

Cited by 50 publications

References 0 publications

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

Real-Time Quantification and Display of Skin Radiation During Coronary Angiography and Intervention

Risk Assessment of Occupational Exposure of Workers Engaged in Radiation Practice without Monitoring Devices

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