Effectiveness of Low Rate Fluoroscopy at Reducing Operator and Patient Radiation Dose During Transradial Coronary Angiography and Interventions
Overview
Authors
Affiliations
Objectives: This study sought to determine the efficacy of low rate fluoroscopy at 7.5 frames/s (FPS) versus conventional 15 FPS for reduction of operator and patient radiation dose during diagnostic coronary angiography (DCA) and percutaneous coronary intervention (PCI) via the transradial approach (TRA).
Background: TRA for cardiac catheterization is potentially associated with increased radiation exposure. Low rate fluoroscopy has the potential to reduce radiation exposure.
Methods: Patients undergoing TRA diagnostic angiography ± ad-hoc PCI were randomized to fluoroscopy at 7.5 FPS versus 15 FPS prior to the procedure. Both 7.5 and 15 FPS fluoroscopy protocols were configured with a fixed dose per pulse of 40 nGy. Primary endpoints were operator radiation dose (measured with dosimeter attached to the left side of the thyroid shield in μSievert [μSv]), patient radiation dose (expressed as dose-area product in Gy·cm(2)), and fluoroscopy time.
Results: From October 1, 2012 to August 30, 2013, from a total of 363 patients, 184 underwent DCA and 179 underwent PCI. Overall, fluoroscopy at 7.5 FPS compared with 15 FPS was associated with a significant reduction in operator dose (30% relative reduction [RR], p < 0.0001); and in patient's dose-area product (19% RR; p = 0.022). When stratified by procedure type, 7.5 FPS compared with 15 FPS was associated with significant reduction in operator dose during both DCA (40% RR; p < 0.0001) and PCI (28% RR; p = 0.0011). Fluoroscopy at 7.5 FPS, compared with 15 FPS, was also associated with substantial reduction in patients' dose-area product during DCA (26% RR; p = 0.0018) and during PCI (19% RR; p = 0.13). Fluoroscopy time was similar in 7.5 FPS and 15 FPS groups for DCA (3.4 ± 2.0 min vs. 4.0 ± 4.7 min; p = 0.42) and PCI (11.9 ± 8.4 min vs. 13.3 ± 9.7 min; p = 0.57), respectively.
Conclusions: Fluoroscopy at 7.5 FPS, compared with 15 FPS, is a simple and effective method in reducing operator and patient radiation dose during TRA DCA and PCI.
Update on Radiation Safety in the Cath Lab - Moving Toward a "Lead-Free" Environment.
Roguin A, Wu P, Cohoon T, Gul F, Nasr G, Premyodhin N J Soc Cardiovasc Angiogr Interv. 2024; 2(4):101040.
PMID: 39131633 PMC: 11307637. DOI: 10.1016/j.jscai.2023.101040.
Alvandi M, Javid R, Shaghaghi Z, Farzipour S, Nosrati S Curr Radiopharm. 2024; 17(3):219-228.
PMID: 38314600 DOI: 10.2174/0118744710283181231229112417.
Vogel P, Ruckert M, Greiner C, Gunther J, Reichl T, Kampf T Sci Rep. 2023; 13(1):10472.
PMID: 37380707 PMC: 10307843. DOI: 10.1038/s41598-023-37351-2.
Cardoso C, de Moraes C, Teixeira J, Cardoso C, Baldissera F, de Mattos E Tex Heart Inst J. 2023; 50(2).
PMID: 36944120 PMC: 10178642. DOI: 10.14503/THIJ-22-7930.
Subban V, Amelot S, Victor S, Potdar A, Yadav V, Patel T AsiaIntervention. 2021; 6(1):25-33.
PMID: 34912981 PMC: 8525728. DOI: 10.4244/AIJ-D-18-00044.