Riscos da Radiação X e a Importância da Proteção Radiológica na Cardiologia Intervencionista: Uma Revisão Sistemática

Abstract

Radiation Risks and the Importance of Radiological Protection in Interventional Cardiology: A Systematic ReviewWe discuss some aspects related to the legal framework, international recommendations and training programs on radiological protection; image quality and equipment; the biological effects and risks of ionizing radiation; lesions in patients and operators; patient's reference levels; occupational dose limit and preventive actions. The use of ionizing radiation involves risks that are justified in diagnostic and therapeu tic procedures. The awareness and knowledge of these risks minimizes the damage, optimizing the quality of images and safe use of ionizing radiation. There is evidence of radiationin duced cataracts in individuals who work in catheterization laboratories. Several studies suggest there may be a significant risk of lens opacity, if radiological protection devices are not properly used. Additionally, these interventional procedures are performed in Latin America, usually by medical specialists in collaboration with nurses, technologists and technicians, who often do not have adequate training in radiological protection.

A bibliographical review on the concept of biological effects of ionizing radiation in Brazilian publications

“…There is also concern with the standards (citing in this case ICRP 10311, which warns of some radiation-associated effects, other than cancer) and the specificity of the lesions in Interventional Cardiology, such as tissue reactions (deterministic effect) and cataract formation, in physicians, and skin lesions in patients. It is also talked about units and doses [14].…”

“…The biological effects caused by high energy ionizing radiation can be divided into deterministic or stochastic. The deterministic effects, or tissue reactions, are characteristic of high doses and depend directly on such exposure, such as cell death (for example, malignant cells undergoing radiotherapy), skin burns, sterility or the occurrence of cataracts (13,14). At low doses, the risks are primarily of stochastic (or random) effects, which are those that are not apparent and that manifest themselves after months or years of exposure to radiation, not allowing a clear "cause and effect" relationship to be established, only a probability which is proportional to the dose.…”

“…At low doses, the risks are primarily of stochastic (or random) effects, which are those that are not apparent and that manifest themselves after months or years of exposure to radiation, not allowing a clear "cause and effect" relationship to be established, only a probability which is proportional to the dose. The most relevant stochastic effects are mutation and carcinogenesis (3,14,15). It is considered that, for stochastic effects, there is a linear dose-response component, without a threshold below which exposure is safe, ie any dose of radiation is likely to cause mutation or cancer (15) [16, p. 214].…”

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

“…The risk is cumulative for patients and professionals, and the greater the number of procedures performed, the greater the doses and the potential risks. [13][14][15][16] There are few reports in the medical literature on radiation doses for patients and health professionals in ad hoc PCI using the radial technique. 15,17 The objective of this study was to compare the radiological variables of staged PCI with ad hoc interventions, using radial access.…”

Tema 6 - Gestão Do Produto

“…Os óculos têm a função de minimizar a probabilidade dos profissionais da saúde desenvolverem opacidade do cristalino (catarata), doença que Leyton et al (2014), mencionaram como sendo uma patologia comum em cerca de 50% dos médicos cardiologistas que realizam procedimentos nos quais são expostos a radiação ionizante. Essa afecção é caracterizada pela diminuição da entrada de luz nos olhos, o que dificulta a formação da imagem perfeita, sem embaçamento.…”