Trends in Patient Exposure to Radiation in Percutaneous Coronary Interventions Over a 10-Year Period

Faroux, Laurent; Blanpain, Thierry; Nazeyrollas, Pierre; Tassan-Mangina, Sophie; Herce, B.; Tourneux, Christophe; Metz, Damien

doi:10.1016/j.amjcard.2017.06.021

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…This radiation exposure is associated with deterministic tissue reactions such as cataracts and skin injuries. Moreover, exposure to low‐dose radiation induces a stochastic risk on various malignancies 1‐4,20‐23 …”

Section: Discussionmentioning

confidence: 99%

The radioprotective effect of the Cathpax® AIR cabin during interventional cardiology procedures

Gutierrez-Barrios

Angulo-Pain

Noval-Morillas

et al. 2021

Catheter Cardiovasc Interv

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Background The use of ionizing radiation during cardiac catheterization interventions adversely impacts the medical staff. Traditional radiation protection equipment is only partially effective. The Cathpax® radiation protection cabin (RPC) has proven to significantly reduce radiation exposure in electrophysiological and neuroradiology interventions. Our objective was to analyze whether the Cathpax® RPC reduces radiation dose in coronary and cardiac structural interventions in unselected real‐world procedures. Methods and Results In this nonrandomized all‐comers prospective study, 119 consecutive cardiac interventional procedures were alternatively divided into two groups: the RPC group (n = 59) and the non‐RPC group (n = 60). No significant changes in the characteristics of patients and procedures, average contrast volume, air kerma (AK), dose area‐product (DAP) and fluoroscopy time between both groups were apparent. In the RPC group, the first‐operator relative radiation exposure was reduced by 78% at the chest and by 70% at the wrist. This effect was consistent during different types of procedures including complex percutaneous interventions and structural procedures. Conclusions Our study demonstrates, for the first time, that the Cathpax® cabin significantly and efficiently reduces relative operator radiation exposure during different types of interventional procedures, confirming its feasibility in a real‐world setting.

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Section: Discussionmentioning

confidence: 99%

The radioprotective effect of the Cathpax® AIR cabin during interventional cardiology procedures

Gutierrez-Barrios

Angulo-Pain

Noval-Morillas

et al. 2021

Catheter Cardiovasc Interv

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“…Ionizing radiation exposure has previously been the subject of investigation for endovascular procedures including EVAR, coronary interventions and peripheral arterial and venous angioplasty and stenting [5][6][7][8][9][15][16][17][18][19] . A systematic review by Monastiriotis and colleagues found that for a regular, infrarenal EVAR, the mean radiation exposure to the patient in DAP was 79.48 Gycm 2 (range 4.3 -619 Gycm 2 ) 5 .…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we have demonstrated that most patients with both LFVM and HFVM undergoing EST, received lower doses of radiation measured in DAP and fluoroscopy time when compared to many common endovascular interventions. These include percutaneous coronary interventions, percutaneous transluminal angioplasty, stenting of the lower limb arteries, iliofemoral vein, inferior vena cava and EVAR (Table IV) 5,7,8,16 . However, the ranges of DAP and fluoroscopy time for single and cumulative EST of both HFVM and LFVM were large, ranging from almost zero to 1300.24 Gycm 2 and 1 to 5843 seconds, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…DAP and fluoroscopy times were used as they are easily obtained as they are automatically computed by modern fluoroscopy units 7,[9][10][11]23 . Furthermore, many studies on radiation exposure, including those for endovascular arterial and deep venous interventions, have reported their findings using these indices, allowing for comparison between studies 5,7,8,16 . However, these comparisons between procedures for differing pathologies should be made cautiously, due the differences in the nature of the pathology, complexity of the interventions and in the patient cohorts studied.…”

Section: Discussionmentioning

confidence: 99%

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Patient radiation exposure from embolo-sclerotherapy of peripheral vascular malformations

Giet

Evans

Papadopoulou

et al. 2021

Journal of Vascular Surgery

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This retrospective study analyzed the radiation exposure for patients who underwent embolosclerotherapy (EST) for peripheral vascular malformations (VMs). The single and cumulative radiation exposure in patients with VMs who had EST were generally less than many common endovascular arterial and deep venous interventions. However, since some patients with VMs received relatively high radiation doses from EST and some require multiple interventions, the authors recommend that clinicians who perform these procedures keep the radiation exposure to a minimum.

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“…Despite the progress in X-ray instrumentation, protection devices, the introduction of robotic PCI, and foremost the increased awareness, the progressively increasing complexity of the procedures performed (including structural and valvular procedures) leads to a constant increase in operator exposure [22][23][24]. This increase was recently quantified in a 54% higher average fluoroscopy time when procedures performed in the year 2016 were compared to those performed 10 years before [25]. This trend obviously represents an issue for new trainees; as well, according to a survey of the women's initiative, radiation exposure may represent a barrier towards gender equality in this field [10].…”

Section: Radiation Exposure In Interventional Cardiology and Interpretation Of The Present Findingsmentioning

confidence: 99%

Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial

Olschewski¹,

Ullrich²,

Brandt³

et al. 2021

JCM

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Background—Several methods to reduce radiation exposure in the setting of coronary procedures are available on the market, and we previously showed that additional radiation shields reduce operator exposure during radial interventions. We set out to examine the efficacy of real-time personal dosimetry monitoring in a real-world setting of radial artery catheterization. Methods and Results—In an all-comer prospective, parallel study, consecutive coronary diagnostic and intervention procedures were performed with the use of standard radiation shield alone (control group) or with the addition of a real-time dosimetry monitoring system (Raysafe, Billdal, Sweden, monitoring group). The primary outcome was the difference in exposure of the primary operator among groups. Additional endpoints included patient, nurse, second operator exposure and fluoroscopy time. A total of 700 procedures were included in the analysis (n = 369 in the monitoring group). There were no differences among groups in patients’ body mass index (p = 0.232), type of procedure (intervention vs. diagnostic, p = 0.172), and patient sex (p = 0.784). Fluoroscopy time was shorter in the monitoring group (5.6 (5.1–6.2) min vs. 7.0 (6.1–7.7) min, p = 0.023). Radiation exposure was significantly lower in the monitoring group for the patient (135 (115–151) µSv vs. 208 (176–245) µSv, p < 0.0001) but not for the first operator (9 (7–11) µSv vs. 10 (8–11), p = 0.70) and the assistant (2 (1–2) µSv vs. 2 (1–2) µSv, p = 0.121). Conclusions—In clinical daily practice, the use of a real-time dosimetry monitoring device reduces patient radiation exposure and fluoroscopy time without an effect on operator radiation exposure.

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Trends in Patient Exposure to Radiation in Percutaneous Coronary Interventions Over a 10-Year Period

Cited by 13 publications

References 19 publications

The radioprotective effect of the Cathpax® AIR cabin during interventional cardiology procedures

The radioprotective effect of the Cathpax® AIR cabin during interventional cardiology procedures

Patient radiation exposure from embolo-sclerotherapy of peripheral vascular malformations

Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial

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