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

2021 ◽  
Vol 10 (22) ◽  
pp. 5350
Author(s):  
Maximilian Olschewski ◽  
Helen Ullrich ◽  
Moritz Brandt ◽  
Sebastian Steven ◽  
Majid Ahoopai ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Real Time ◽  
Daily Practice ◽  
Fluoroscopy Time ◽  
Control Group ◽  
Reduce Radiation Exposure ◽  
Primary Operator ◽  
Monitoring Group ◽  
Coronary Procedures ◽  
The Difference

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.

Radiation safety during percutaneous coronary procedures: how to reduce radiation exposure and its complications

2008 ◽  
Vol 4 (2) ◽  
pp. 187-188 ◽  
Author(s):  
Didier Locca ◽  
Malcolm Bell ◽  
Francis Verdun ◽  
Jean-Christophe Stauffer
Keyword(s):  
Radiation Exposure ◽  
Radiation Safety ◽  
Reduce Radiation Exposure ◽  
Percutaneous Coronary ◽  
Coronary Procedures

scholarly journals The importance of ultrasound in the diagnosis of pleura complications of acute destructive pneumonia in children

2021 ◽  
Vol 16 (7) ◽  
pp. 484-486
Author(s):  
V.A. Dihtiar ◽  
A.A. Halahan ◽  
D.M. Lukianenko
Keyword(s):  
Radiation Exposure ◽  
Real Time ◽  
Inpatient Treatment ◽  
Age Groups ◽  
Diagnosis And Treatment ◽  
Ultrasound Diagnosis ◽  
Free Fluid ◽  
Treatment Methods ◽  
Reduce Radiation Exposure ◽  
Timely Diagnosis

Background. The problem of timely diagnosis of complications of acute destructive pneumonia accompanied by pyofibrothorax remains relevant. The study was aimed to investigate the features of ultrasound diagnosis (ultrasound) of the condition of the visceral and parietal pleural lamina in acute destructive pneumonia in children at different stages of the disease. Materials and methods. In the departments of purulent surgery and pulmonology of the Regional Children’s Hospital of Dnipro for the period of 5 years, there were observed about 475 children aged from 1 to 17 years with pneumonia, purulent-destructive changes in the lungs and pleura. For analysis and further study, we choose a group of 50 patients of different age groups, who underwent ultrasound in real time without prior preparation of patients. The condition of the parietal and visceral pleural lamina at the different stages of diagnosis and treatment was studied. Results. A group of patients aged from 4 to 10 years was performed an ultrasound of the pleural cavities in real time without prior preparation on the paraspinal, scapular, axillary, midclavicular, and thoracic lines when admitted to the hospital and on the first day of treatment. Ultrasound was used to determine the structure and volume of free fluid as well as the condition of the parietal and visceral pleural lamina, their thickness, and other features. The use of ultrasound allowed diagnosing the early manifestations of pyofibrothorax and determining the condition of the parietal and visceral pleural lamina in the children with destructive pneumonia. Conclusion. Further improvement of the algorithm of ultrasound diagnosis of acute destructive pneumonia in children with pyofibrothorax will reduce radiation exposure to a child’s body, increase the efficiency of the development and improvement of treatment methods at the stages of pyofibrotorax, reduce the duration of inpatient treatment.

scholarly journals Effectiveness of Tirobot-assisted Vertebroplasty in Treating Thoracolumbar Osteoporotic Compression Fracture

2020 ◽  
Author(s):  
Boyao Wang ◽  
Jiang Cao ◽  
Jie Chang ◽  
Guoyong Yin ◽  
Weihua Cai ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Traditional Approach ◽  
Compression Fracture ◽  
Cement Leakage ◽  
Control Group ◽  
Osteoporotic Compression Fracture ◽  
Reduce Radiation Exposure ◽  
Operative Duration ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background: Percutaneous kyphoplasty is the main method for the treatment of thoracolumbar osteoporotic compression fractures. However, much radiation exposure during the operation could harm the health of the surgeon and the patient. In addition, the accuracy of its surgery still needs to be improved. This study aimed to assess the radiation exposure and clinical efficacy of Tirobot-assisted vertebroplasty in treating thoracolumbar osteoporotic compression fracture.Methods: A total of 60 patients with thoracolumbar osteoporotic compression fracture who underwent unilateral vertebroplasty at our hospital between June 2019 and June 2020 were included in this retrospective cohort study. All of them were between 60 and 90 years old and free of systemic diseases. All the patients were assigned to Tirobot group (treated with Tirobot-assisted approach) and control group (treated with traditional approach). Fluoroscopic frequency, operative duration, length of stay (LOS), post-operative complications (cement leakage, infection, and thrombosis), pre-operative and pre-discharge indexes (VAS scores, JOA scores, and Cobb’s angles) were compared.Results: The fluoroscopic frequency(P<0.001), post-operative complications(P=0.035) in Tirobot group was significantly lower than those in control group. The operative duration and LOS in Tirobot group were shorter than those in control group, but the differences were not statistically significant (P=0.183). Pre-discharge VAS score and Cobb’s angle decreased, and JOA increased after surgeries in both groups. These three indexes showed significant differences after surgery in each group (P<0.001), but not between groups (PVAS=0.175, PCobb’s=0.585, PJOA =0.448).Conclusion: As a safe and effective strategy, Tirobot-assisted vertebroplasty can reduce radiation exposure and be clinically replicated.

scholarly journals The Impact of Experience on Fluoroscopy Time for Peripherally Inserted Central Venous Catheters in a Pediatric Population: A Retrospective Review

2020 ◽  
Vol 3 ◽  
Author(s):  
Isaac Schumacher ◽  
Paul Haste
Keyword(s):  
Radiation Exposure ◽  
Pediatric Population ◽  
Venous Catheter ◽  
Fluoroscopy Time ◽  
Medical Procedures ◽  
Central Venous ◽  
Interventional Radiologist ◽  
Reduce Radiation Exposure ◽  
Significant Difference ◽  
The Impact

Background:  It is established that radiation exposure carries a risk for children. The best approach is to use the As Low As Reasonably Achievable (ALARA) principle for medical procedures. Peripherally inserted central venous catheter (PICC) placements expose children to a variable amount of radiation. The purpose of this study was to try and determine if procedural experience plays a part in reducing radiation exposure during PICC placements.    Methods:  Pediatric PICC placements by a junior attending pediatric interventional radiologist (JrIR) were reviewed, analyzing for a primary end point of fluoroscopy time (FT). These values were also compared to those of trainees and of a senior pediatric interventional radiologist (SrIR) with 15+ years of experience. Statistical analysis included the Mann-Whitney U test. P values < .05 were considered significant.    Results:  FT for 685 trainee, 459 JrIR, and 425 SrIR PICC placements were analyzed. No statistically significant decreasing trend in FT was noted for either the JrIR or SrIR over the course of the study period. Trainees required significantly more FT than the JrIR (Trainees = .80 min, JrIR = .70 min, P = .004) or the SrIR (SrIR = .60 min, P < .001), but there was no significant difference between the JrIR and SrIR (P = .058). Furthermore, trainees supervised by non-pediatric IRs had even greater median FT (1.30 min). All of these differences were significantly greater in smaller patients (Age <1) and cases in which increased procedural difficulty was encountered.    Conclusion:  This study suggests that the experience of the proceduralist may reduce radiation exposure in PICC placements, but it does not seem to support linear improvement early in a primary operator’s career. The results raise the question as to why the differences exist and may support the use of FT as a metric for analyzing proficiency in IR procedures.  

scholarly journals DOES THE USE OF DEXMEDETOMIDINE AFFECT THE OUTCOMES IN PATIENTS WITH SEVERE COVID-19?

2021 ◽  
Author(s):  
Kubilay İşsever ◽  
Ahmed Cihad Genç ◽  
Deniz Çekiç ◽  
Ahmed Bilal Genc ◽  
Selcuk Yaylaci ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Patient Group ◽  
Ivig Therapy ◽  
Daily Practice ◽  
Mortality Rates ◽  
Control Group ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
The Difference

Objective: Dexmedetomidine (DEX) is a highly selective α2-adrenoceptor agonist that is increasingly used in the daily practice of intensive care units (ICUs) with its sedative, analgesic, anxiolytic, and immunoprotective effects. In this study, we aimed to analyze whether Dexmedetomidine improves the outcomes in patients treated in ICU. Design: A retrospective study Place and Duration of Study: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to February 2021 Methodology: The medical records of the patients were analyzed retrospectively. We included 134 patients in the study, in 45 of whom the treatment regimen included dexmedetomidine and 89 of whom were not treated with dexmedetomidine. Patients treated with DEX were defined as the “patient group”, whereas patients not treated with DEX were defined as “control group” and the parameters were compared between these groups. Obtained data were analyzed in the biostatistical program. Results: The median age of all patients was 64 and 62.7% of them were male. No significant difference was found between the groups in terms of median ages (p>0.05). The patients with diabetes mellitus (DM), congestive heart failure (CHF), and undergoing insulin treatment were significantly less treated with DEX (p=0.04, p=0.03, and p=0.016 respectively) whereas intravenous immunoglobulin (IVIG) therapy was found to be more frequently applied to the patient group (p=0.043). The median duration between ICU admission and the time of intubation was 4 days for the control group whereas it was 1 day for the patient group and the difference was strongly significant (p=0.000, p<0.001). The other analyses concerning lab parameters, mortality rates, intubation rates and durations, applied treatments, and comorbidities revealed no significant difference between the groups. Conclusion: Our study revealed that DEX therapy can help us to gain time before intubation however can not reduce mortality rates in severe COVID-19.

scholarly journals Do we need imaging support to minimize radiation exposure in cryo-ablation for atrial fibrillation? The VLADIMIR strategy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Guisasola Cienfuegos ◽  
C Lazaro Rivera ◽  
A Marco Del Castillo ◽  
M.M Otero Escudero ◽  
J Ramos Jimenez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiation Exposure ◽  
Intracardiac Echocardiography ◽  
Fluoroscopy Time ◽  
End Points ◽  
Dose Area Product ◽  
Reduce Radiation Exposure ◽  
Funding Sources ◽  
Novel Strategy ◽  
Area Product

Abstract Introduction and objective Cryoballoon pulmonary vein isolation (CB-VPI) is non-inferior to radiofrequency ablation in patients with atrial fibrillation. Although protocols aiming to reduce radiation exposure have been developed, most of them use intracardiac echocardiography (ICE) or electroanatomic mapping (EAM) systems, which significantly increase procedure costs or may not be widely available. Previous studies aiming at fluoroscopy reduction have been published, achieving median fluoroscopy times around 10 minutes. We developed a novel strategy to achieve Very Low rADIoscopic exposure to Minimize Ionizing Radiation during cryoablation of atrial fibrillation (VLADIMIR) (Table 1). The aim of this study was to assess its impact in acute procedural and clinical outcomes. Methods Consecutive patients undergoing CB-VPI were prospectively enrolled, treated with the VLADIMIR strategy and compared to a retrospective cohort of patients having undergone CB-VPI performed by the same operators with conventional fluoroscopy strategy. Primary end-points were fluoroscopy time and total dose area product (DAP). Secondary end-points were intraprocedural or early post-procedural complications. Results A total of 84 patients were enrolled. 50 patients underwent CB-VPI with conventional fluoroscopy strategy and in 34 patients the Vladimir strategy was applied. Vladimir group had significant lower median fluoroscopy time (2.98 min vs 20.65 min, p&lt;0.001) and significant lower median DAP (4.15 Gy·cm2 vs 34.12 Gy·cm2, p&lt;0.001) as compared with conventional fluoroscopy strategy group. Results from prespecified subgroup analysis between operators (senior vs fellow trainee) were consistent. No significant differences were found between both groups in periprocedural complications (Table 2). Conclusion The Vladimir protocol significantly reduces fluoroscopy time and radiation exposure during CB-VPI without affecting the rate of periprocedural complications. FUNDunding Acknowledgement Type of funding sources: None. Table 1. The VLADIMIR strategy Table 2

Sonography of Magnetically Controlled Growing Rods: A Quality Initiative in the Creation of a Multidisciplinary Clinic

2020 ◽  
Vol 36 (6) ◽  
pp. 520-528
Author(s):  
Monique C. Riemann ◽  
Smita S. Bailey ◽  
Nicholas Rubert ◽  
Craig E. Barnes ◽  
Judson W. Karlen
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Average Length ◽  
Imaging Data ◽  
Growing Rods ◽  
Reduce Radiation Exposure ◽  
Reduce Radiation Dose ◽  
The Difference ◽  
Magnetically Controlled Growing Rods ◽  
Dicom Imaging

Objective: The MAGEC (Magnetic Expansion Control) rods were introduced to a medical institution in 2015. The rod expansion procedures were initially evaluated with radiographs. The staff undertook a quality initiative to reduce radiation exposure by utilizing sonography. Material and Methods: The radiation dose for a typical visit was measured by examining DICOM imaging data, stored in PACS. Imaging visit time was determined from the difference between times of first radiograph/sonogram before distraction to last radiograph/sonogram after distraction. Results: The 21 patients (8 male, 13 female) were an average age of 11.4 ± 2.82 years (age at implant = 7.5 ± 1.94) when evaluated. The average length of time for a radiographic visit was 40.7 ± 20.7 minutes, whereas a sonography visit was 10.7 ± 3.7 minutes. Radiation dose per study visit prior to the introduction of the MAGEC clinic was 0.42 ± 0.39 mSv. Given an ideal patient schedule, the MAGEC clinic could reduce radiation dose by 1.3 to 2.5 mSv annually, with 95% confidence. Conclusion: This quality improvement study demonstrated a reduction in radiation exposure and imaging time. The added benefits were providing a successful multidisciplinary imaging clinic and creation of a new exam that aligned with the “ultrasound first” initiative.

Utilising electroanatomic mapping during ablation in patients with CHD to reduce radiation exposure

2021 ◽  
pp. 1-5
Author(s):  
Maryam Rahman ◽  
Jeremy P. Moore ◽  
John Papagiannis ◽  
Grace Smith ◽  
Chris Anderson ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiation Exposure ◽  
Three Dimensional ◽  
Fluoroscopy Time ◽  
Electroanatomic Mapping ◽  
Complication Rates ◽  
Procedure Time ◽  
Reduce Radiation Exposure ◽  
Three Dimensional Mapping ◽  
Procedural Success

Abstract Background: Patients with CHD can be exposed to high levels of cumulative ionising radiation. Utilisation of electroanatomic mapping during catheter ablation leads to reduced radiation exposure in the general population but has not been well studied in patients with CHD. This study evaluated the radiation sparing benefit of using three-dimensional mapping in patients with CHD. Methods: Data were retrospectively collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy multi-institutional registry. Patients with CHD were selected. Those with previous ablations, concurrent diagnostic or interventional catheterisation and unknown arrhythmogenic foci were excluded. The control cohort was matched for operating physician, arrhythmia mechanism, arrhythmia location, weight and age. The procedure time, rate of fluoroscopy use, fluoroscopy time, procedural success, complications, and distribution of procedures per year were compared between the two groups. Results: Fifty-six patients with congenital heart disease and 56 matched patients without CHD were included. The mean total procedure time was significantly higher in patients with CHD (212.6 versus 169.5 minutes, p = 0.003). Their median total fluoroscopy time was 4.4 minutes (compared to 1.8 minutes), and their rate of fluoroscopy use was 23% (compared to 13%). The acute success and minor complication rates were similar and no major complications occurred. Conclusions: With the use of electroanatomic mapping during catheter ablation, fluoroscopy use can be reduced in patients with CHD. The majority of patients with CHD received zero fluoroscopy.

scholarly journals Digital variance angiography allows about 70% decrease of DSA-related radiation exposure in lower limb X-ray angiography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marcell Gyánó ◽  
Márton Berczeli ◽  
Csaba Csobay-Novák ◽  
Dávid Szöllősi ◽  
Viktor I. Óriás ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Lower Limb ◽  
Low Dose ◽  
X Ray ◽  
Reduce Radiation Exposure ◽  
Significant Difference ◽  
Region Difference ◽  
Diagnostic Angiography ◽  
The Difference ◽  
Artery Disease

AbstractOur aim was to investigate whether the previously observed higher contrast-to-noise ratio (CNR) and better image quality of Digital Variance Angiography (DVA) - compared to Digital Subtraction Angiography (DSA) - can be used to reduce radiation exposure in lower limb X-ray angiography. This prospective study enrolled 30 peripheral artery disease patients (mean ± SD age 70 ± 8 years) undergoing diagnostic angiography. In all patients, both normal (1.2 µGy/frame; 100%) and low-dose (0.36 µGy/frame; 30%) protocols were used for the acquisition of images in three anatomical regions (abdominal, femoral, crural). The CNR of DSA and DVA images were calculated, and the visual quality was evaluated by seven specialists using a 5-grade Likert scale. For investigating non-inferiority, the difference of low-dose DVA and normal dose DSA scores (DVA30-DSA100) was analyzed. DVA produced two- to three-fold CNR and significantly higher visual score than DSA. DVA30 proved to be superior to DSA100 in the crural region (difference 0.25 ± 0.07, p < 0.001), and there was no significant difference in the femoral (− 0.08 ± 0.06, p = 0.435) and abdominal (− 0.10 ± 0.09, p = 0.350) regions. Our data show that DVA allows about 70% reduction of DSA-related radiation exposure in lower limb X-ray angiography, providing a potential new radiation protection tool for the patients and the medical staff.

Sign in / Sign up

Export Citation Format

Share Document