Radiodermatitis following cardiac catheterization

D’Incan, M.

doi:10.1001/archderm.133.2.242

Cited by 18 publications

(7 citation statements)

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“…[12][13][14][15][16] The International Commission on Radiological Protection recommends that the maximum skin dose and its location should be recorded when the maximum cumulative skin dose is supposed to be 3 Gy or more (1 Gy or more in repeat cases). 17 In our assessment of 23 PCI procedures for CTO, the maximum ESDs exceeded 1 Gy and 3 Gy in 21 and 10 procedures, respectively.…”

Section: Patient Esd During Pci For Ctomentioning

confidence: 99%

Factors Affecting the Patient's Skin Dose During Percutaneous Coronary Intervention for Chronic Total Occlusion

Suzuki

Furui

Isshiki

et al. 2007

Circ J

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hronic total occlusion (CTO) has been considered as a relative contraindication for percutaneous coronary intervention (PCI), because of its low success rate and high restenosis rate. The results have improved because of recent advances in technology and increased operator experience. [1][2][3][4][5][6][7] Recent studies show that successful PCI of a CTO is associated with improved survival; 8,9 however, the total fluoroscopic time (TFT) tends to be long in this procedure compared with PCI for non-CTO. 10 The patient's entrance skin doses (ESD) are higher 10,11 and severe skin injury can occur, so the physician must estimate the ESD in order to prevent radiation skin injuries during the procedure. However, there is inadequate assessment of this issue in the literature.The purpose of this research was to measure the patient's ESD during PCI for CTO, analyze the factors that affect it and assess the methods used to estimate the maximum ESD from both patient and angiographic data. Circulation Journal Vol.71, February 2007 Methods Patient PopulationThis study focused on 23 consecutive patients (6 women, 17 men) who underwent PCI for CTO with evaluation of the ESDs from July 2004 to September 2005. The average patient age was 68.9±7.7 years (range: 53.6-82.2). AngiographyAdvantX LC and AdvantX LC/LP equipment (General Electric Medical Systems, Milwaukee, WI, USA) were used for angiography. The image intensifiers of both units were renewed in April 2004. Each unit had an undercouch tube and an overcouch image intensifier with 3 fields of view: 9, 6, and 4.5 inches in diameter. A 6-inch field of view was used mainly in this assessment. In both units, the total filtration was equivalent to 2.7 mm aluminum. Procedures were performed using pulse-mode fluoroscopy. The period of use was 9 years for each unit. PCI and ESD MeasurementThe patient wore a jacket with 52 radiosensitive indicators (Nichiyu Giken Kogyo Co, Ltd, Saitama, Japan) placed on the back. Radiosensitive indicators use a functional dye in which the color changes from translucent to red with Xray absorption. Indicators were arranged in 6 rows (from top to bottom: 1, 2, 3, 4, 5, and 6) and 8 columns (from left to right: A, B, C, D, E, F, G, and H) at intervals of 7 cm. An additional 4 indicators were placed in the 7th row (C7, D7, E7, and F7), except for 2 patients. Four experienced cardiologists performed the procedures using standard tech- Background The aim of this study was to measure the patient entrance skin dose (ESD) during percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), and assess the factors that affect it. Methods and ResultsRadiosensitive indicators were used to measure ESDs during 23 procedures. Multiple regression analysis identified the strength of the linear relationship of the dependent variable (the natural logarithm of the maximum ESD) with the set of multiple independent variables (the natural logarithm of both the patient and angiographic data). The methods for estimating the maximum ESD and the estimated ESDs w...

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Section: Patient Esd During Pci For Ctomentioning

confidence: 99%

Factors Affecting the Patient's Skin Dose During Percutaneous Coronary Intervention for Chronic Total Occlusion

Suzuki

Furui

Isshiki

et al. 2007

Circ J

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“…In some cases, even if the patient mentions prior fluoroscopy, the dermatologist has disregarded fluoroscopy as a possible cause because of lack of experience with the high doses from these procedures. In our review of 73 patients [30], an initial diagnosis of a fixed drug eruption, morphea (circumscribed cutaneous scleroderma), contact dermatitis, viral or bacterial infection, or a spider bite was made, [7,11,12,24], including four from this report. Consequently, the correct diagnosis was delayed.…”

Section: Diagnosis Of Radiation-induced Skin Injurymentioning

confidence: 99%

Skin Injuries from Fluoroscopically Guided Procedures

Koenig

Wolff²,

Mettler

et al. 2001

American Journal of Roentgenology

433

225

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“…The development of interventional cardiology procedures involving radiation is responsible for chronic radiodermatitis. The incidence of cutaneous complications of percutaneous coronary interventions (PCI) may be underestimated [3]. The diagnosis may not be made by interventional cardiologists because the lesions can occur several months or years after PCI, sometimes in the absence of prior acute radiodermatitis.…”

Section: Discussionmentioning

confidence: 99%