CONTEMPORARY RADIATION DOSES IN INTERVENTIONAL CARDIOLOGY: A NATIONWIDE STUDY OF PATIENT SKIN DOSES IN FINLAND

2019 ◽  
Vol 188 (2) ◽  
pp. 181-190
Author(s):  
Jukka Järvinen ◽  
Joanna Sierpowska ◽  
Teemu Siiskonen ◽  
Minna Husso ◽  
Hannu Järvinen ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Local Skin ◽  
Transcatheter Aortic Valve ◽  
Percutaneous Coronary ◽  
Data Points ◽  
To Come ◽  
Skin Doses ◽  
Area Product ◽  
Related Harm

Abstract In contemporary interventional cardiology, for typical elderly patients, the most severe radiation-related harm to patients can be considered to come from skin exposures. In this paper, maximum local skin doses in cardiological procedures are explored with Gafchromic film dosimetry. Film and reader calibrations and reading were performed at the Secondary Standards Dosimetry Laboratory of the Radiation and Nuclear Safety Authority (STUK), and data were gathered from seven hospitals in Finland. As alert levels for early transient erythema, 200 Gycm2 kerma area product (KAP) and 2000 mGy air kerma levels for transcatheter aortic valve implantations (TAVI) procedures are proposed. The largest doses were measured in TAVI (4158.8 mGy) and percutaneous coronary interventions (PCI) (941.68 mGy). Accuracies of the GE DoseWatch and Siemens CareMonitor skin dose estimates were reasonable, but more results are needed to reliably assess and validate the tools’ capabilities and reliabilities. Uncertainty of the Gafchromic dosimetry was estimated as 9.1% for a calibration with seven data points and 19.3% for a calibration with five data points.

RADIATION DOSE TO PATIENTS IN CORONARY INTERVENTIONAL PROCEDURES: A SURVEY

2018 ◽  
Vol 184 (1) ◽  
pp. 1-4 ◽  
Author(s):  
A Brindhaban
Keyword(s):  
Interventional Procedures ◽  
Coronary Intervention ◽  
Skin Dose ◽  
Radiation Doses ◽  
Dose Area Product ◽  
Maximum Value ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Area Product ◽  
Peak Skin Dose

Abstract The objective of this study was to evaluate dose–area product (DAP) and peak skin dose (PSD) for coronary angiography (CA) and percutaneous coronary intervention (PCI). The DAP and PSD of 300 randomly selected patients who were referred to CA and/or PCI, over a period of 3 months were recorded and analyzed. The mean DAP of 32 Gy cm2 and mean PSD of 412 mGy for CA were lower than 118 Gy cm2 and 857 mGy, respectively, for PCI. The DAP range of 2–84 Gy cm2 for CA and 12–378 mGy for PCI were also established. The maximum value of PSD for PCI procedures reached above the 2 Gy threshold for erythema. However, these values are similar to those available in literature. Periodic surveys may be required to monitor and/or reduce radiation doses in coronary interventional procedures.

AN ASSESSMENT OF RADIATION EXPOSURE DOSES IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION BASED ON ANGIOGRAPHIC RECORDS

2018 ◽  
Vol 183 (4) ◽  
pp. 475-482 ◽  
Author(s):  
M Maghbool ◽  
M A Hosseini
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radiation Dose ◽  
Primary Percutaneous Coronary Intervention ◽  
Standard Dose ◽  
Coronary Intervention ◽  
Skin Dose ◽  
Dose Area Product ◽  
Percutaneous Coronary ◽  
Using Data ◽  
Area Product

Abstract The stochastic and non-stochastic (deterministic) effects of radiation dose in patients undergoing primary percutaneous coronary intervention (PPCI) have been investigated using data recorded by an angiographic monitoring system. A total of 132 patients with acute myocardial infarction referred to the angiography department of Vali-Asr hospital, Fasa, Iran, during the second half of 2016 were recruited. Quantities like dose–area product (DAP), total air kerma (Ka,r) and fluoroscopy time (FT) were calculated and converted into effective dose (ED) and peak skin dose (PSD). The values for Ka,r, DAP and FT equaled 80 399.20 ± 63 312 mGy cm2, 1392.80 ± 1155.373 mGy and 524.11 ± 423.057 s, respectively, which were within the ranges reported in previous studies. After considering standard dose thresholds for Ka,r and PSD, it was revealed that only a small portion of patients had reached these thresholds and exceeded them (<3%). Moreover, ED < 20 mSv for the majority of patients was fairly consistent with results from a recent research in eight Belgian hospitals. It was shown that angiographic records are reliable for assessing radiation dose in patients.

scholarly journals Patient Peak Skin Dose and Dose Area Product from Interventional Cardiology Procedures

2015 ◽  
Vol 04 (01) ◽  
pp. 7-12 ◽  
Author(s):  
Antar E. Aly ◽  
Ibrahim M. Duhaini ◽  
Samia M. Manaa ◽  
Sayed M. Tarique ◽  
Shehim E. Kuniyil ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Dose Area Product ◽  
Area Product ◽  
Peak Skin Dose

Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project

2021 ◽  
pp. 028418512110620
Author(s):  
Joelle Ann Feghali ◽  
Julie Delépierre ◽  
Olivera Ciraj Belac ◽  
Jérémie Dabin ◽  
Marine Deleu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Predictive Models ◽  
A Priori ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Skin Dose ◽  
A Posteriori ◽  
Tube Voltage ◽  
Percutaneous Coronary ◽  
Peak Skin Dose

Background Optimizing patient exposure in interventional cardiology is key to avoid skin injuries. Purpose To establish predictive models of peak skin dose (PSD) during percutaneous coronary intervention (PCI), chronic total occlusion percutaneous coronary intervention (CTO), and transcatheter aortic valve implantation (TAVI) procedures. Material and Methods A total of 534 PCI, 219 CTO, and 209 TAVI were collected from 12 hospitals in eight European countries. Independent associations between PSD and clinical and technical dose determinants were examined for those procedures using multivariate statistical analysis. A priori and a posteriori predictive models were built using stepwise multiple linear regressions. A fourfold cross-validation was performed, and models’ performance was evaluated using the root mean square error (RMSE), mean absolute percentage error (MAPE), coefficient of determination (R²), and linear correlation coefficient (r). Results Multivariate analysis proved technical parameters to overweight clinical complexity indices with PSD mainly affected by fluoroscopy time, tube voltage, tube current, distance to detector, and tube angulation for PCI. For CTO, these were body mass index, tube voltage, and fluoroscopy contribution. For TAVI, these parameters were sex, fluoroscopy time, tube voltage, and cine acquisitions. When benchmarking the predictive models, the correlation coefficients were r = 0.45 for the a priori model and r = 0.89 for the a posteriori model for PCI. These were 0.44 and 0.67, respectively, for the CTO a priori and a posteriori models, and 0.58 and 0.74, respectively, for the TAVI a priori and a posteriori models. Conclusion A priori predictive models can help operators estimate the PSD before performing the intervention while a posteriori models are more accurate estimates and can be useful in the absence of skin dose mapping solutions

scholarly journals Comparison of Calculated Skin Doses in Cineradiography and Four Dimensional Kinematic Computed Tomography of the Wrist

2020 ◽  
Author(s):  
Leonie Goelz ◽  
Ariane Asmus ◽  
Simon Kim ◽  
Joscha Diehl ◽  
Andreas Eisenschenk ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Diagnostic Value ◽  
Skin Dose ◽  
Dose Length Product ◽  
4D Ct ◽  
Dose Area Product ◽  
Ct Dose ◽  
Effective Doses ◽  
Skin Doses ◽  
Area Product

Abstract Background: Previous studies have discussed the diagnostic value of four dimensional kinematic CT in cases of carpal instabilities. This analysis compares calculated skin doses of 4D CT and conventional cineradiography of the wrist in cases of suspected SLL rupture.Methods: Retrospective calculation and interpolation of skin doses and effective doses for ten consecutive 4D CT examinations and 41 cineradiographies for suspected lesions of the scapholunate ligament. Standardised anterior-posterior and lateral cine sequences using a flat-panel digital subtraction imager and of 4D kinematic CT using a dual-source scanner were acquired and acquisition parameters recorded. We tested if the skin dose of 4D CT is different from cineradiography. Results: Median dose area product (DAP) of cineradiography was 135.34 cGycm 2 resulting in a calculated median skin dose of 32.6 mSv (confidence interval 26.86-42.90 mSv) and an estimated effective skin dose of 3.26 µSv. CT dose index (CTDI) for 4D examinations was recorded to be 26.79 mGy and the dose-length product (DLP) was 150 mGy*cm. This resulted in an estimated skin dose of 34 mSv, which is covered by the confidence interval of cineradiography, and an effective skin dose of 3.4 µSv. Conclusions: Skin dose calculations are comparable for 2D cineradiography in two plains and 4D kinematic CT of the wrist. Calculated effective doses are <0.01 mSv.

Skin dose and dose–area product values for interventional cardiology procedures

2001 ◽  
Vol 74 (877) ◽  
pp. 48-55 ◽  
Author(s):  
E Vano ◽  
L Gonzalez ◽  
J I Ten ◽  
J M Fernandez ◽  
E Guibelalde ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Dose Area Product ◽  
Area Product

scholarly journals Assessment of Patient Dose with Special Look at Pediatrics during Cardiovascular Imaging

2018 ◽  
Author(s):  
P Mehnati ◽  
M Asghari Jafarabadi ◽  
L Danaee
Keyword(s):  
Interventional Cardiology ◽  
Cardiovascular Imaging ◽  
Patient Dose ◽  
Fluoroscopy Time ◽  
Skin Dose ◽  
Dose Area Product ◽  
Number Of Children ◽  
Imaging Center ◽  
High Fluorescence ◽  
Area Product

Aim: During interventional cardiology processes, patients especially women and children receive high radiation doses due to their sensitivities. In this study, we evaluated a pediatric patient dose separately in those undergone intervention cardiac procedure.Methods: In a public hospital with 252 patients, Entrance Skin Dose (ESD) and Dose-Area Product (DAP) were recorded. Prior to the beginning of fluoroscopic procedure, the chest thickness and Body Mass Index (BMI) of patients were measured. Furthermore, kV, mAs, an angle of tube and time of angiography and angioplasty were recorded.Results: Children ratio to all patients underwent the cardiovascular imaging was 1.8. The means of patients' ESD, DAP and fluoroscopy time were 178.3±17 mGy, 1123.6±11 μGym2 and 281.4±181.2 s, respectively for coronary angiography. In coronary angioplasty, the increase in ESD, DAP and fluoroscopy times were observed. In children with congenital heart disease, ESD mean, DAP and fluoroscopy time were 24.0±9.8 mGy, 147.8±62 μGym2, and 552±72s, respectively. The females were 96.8 under 30 years and their dose mean was 276±37 mGy, 368±24 μGym2 for ESD and DAP received, respectively with 376s fluoroscopy time. More than 37% of patients had (25-30) BMI. The relation between the patients’ BMI and DAP was significant (p=0.0001). Mean mAs was 359±34 and kV was 71.23±2.7. Above all, a direct and significant correlation was found between the patients’ chest thickness with variation kV (p=0.037, r=0.11) and mAs (p<0/001, r =0/28).Conclusion: The results demonstrated that the number of children referred to the cardiologic part of the heart and the also dose rate received by them during this test were higher than the data provided for children in developing countries, thus the factors causing such diseases require more attention. Moreover, the number of women was more than twice the referred patients to the heart imaging center, the doses received by these women can be causes of maternal diseases in children. Paying attention to the children's perception of high-fluorescence time is necessary in comparison with total angiography time in order to reduce the number of radiation injuries among pediatrics.

Rescue Transcatheter Aortic Valve Implantation and Simultaneous Percutaneous Coronary Intervention on Cardiopulmonary Bypass in a Patient with an Extreme Risk Profile

2012 ◽  
Vol 15 (3) ◽  
pp. 164 ◽  
Author(s):  
Miralem Pasic ◽  
Stephan Dreysse ◽  
Evgenij Potapov ◽  
Axel Unbehaun ◽  
Semih Buz ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Coronary Revascularization ◽  
Multiorgan Failure ◽  
Coronary Intervention ◽  
Risk Scores ◽  
Transcatheter Aortic Valve ◽  
Percutaneous Coronary ◽  
Aortic Valve Implantation ◽  
Valve Implantation

We report on successful emergency transcatheter aortic valve implantation combined with percutaneous coronary revascularization in a polymorbid and preterminal patient in profound cardiogenic shock and with multiorgan failure. The risk scores were almost unbelievably high (Society of Thoracic Surgeons mortality score, 83.9%; Society of Thoracic Surgeons morbidity and mortality score, 96.8%; logistic EuroSCORE, 96.7%). Two and a half years after the procedure, the patient is doing very well.

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