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Fluoroscopy pulse rate reduction during diagnostic and therapeutic imaging in the cardiac catheterization laboratory: An evaluation of radiation dose, procedure complications and outcomes.
- Source :
-
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2017 Mar 01; Vol. 89 (4), pp. 665-670. Date of Electronic Publication: 2016 Apr 28. - Publication Year :
- 2017
-
Abstract
- Objectives: To evaluate radiation reduction by reducing fluoroscopy pulse rate in diagnostic cardiac catheterizations and percutaneous coronary interventions (PCI) as well as outcomes at 30 days and six months.<br />Background: Radiation exposure to the public at large has increased dramatically over the past three decades, and the cardiac catheterization laboratory is a large contributor. Fluoroscopy pulse rate is one way to decrease radiation exposure.<br />Methods: Fluoroscopy pulse rate was reduced from 10 pulses/sec (p/s) to 7.5 p/s as part of an internal quality improvement project. A retrospective analysis of all cardiac catheterizations was performed, evaluating Air KERMA at the interventional reference point (K <subscript>a, r</subscript> ), Air KERMA area product (P <subscript>KA</subscript> ), procedural complications and major adverse cardiac events at 30 days and 6 months.<br />Results: In diagnostic catheterization median P <subscript>KA</subscript> (µGy·m <superscript>2</superscript> ) and K <subscript>a,r</subscript> (mGy) were significantly reduced (P <subscript>KA</subscript> - 5,613.3 vs. 4,400, P < 0.001; K <subscript>a,r</subscript> - 703.0 vs. 621.0, P = 0.041). In PCI, median P <subscript>KA</subscript> and K <subscript>a,r</subscript> were further reduced (P <subscript>KA</subscript> - 13,481.6 vs. 10,648.0, P < 0.001; K <subscript>a,r</subscript> - 1787.0 vs. 1,459.0, P = 0.002). There was no difference in complications, fluoroscopy time or number of stents placed. There was no difference in MACE after adjustment for number of STEMIs.<br />Conclusions: Reducing fluoroscopy pulse rates to 7.5 from 10 is an effective way to reduce patient radiation exposure across meaningful dose indices. A pulse rate of 7.5 p/s is safe, with no difference in complications or outcomes. A fluoroscopy pulse rate of 7.5 p/s should be given strong consideration for a new standard. © 2016 Wiley Periodicals, Inc.<br /> (© 2016 Wiley Periodicals, Inc.)
- Subjects :
- Coronary Angiography
Coronary Artery Disease diagnosis
Coronary Artery Disease surgery
Female
Humans
Incidence
Male
Middle Aged
Pennsylvania epidemiology
Percutaneous Coronary Intervention
Radiation Dosage
Radiation Injuries epidemiology
Retrospective Studies
Risk Factors
Cardiac Catheterization methods
Fluoroscopy methods
Radiation Injuries prevention & control
Risk Assessment methods
Subjects
Details
- Language :
- English
- ISSN :
- 1522-726X
- Volume :
- 89
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
- Publication Type :
- Academic Journal
- Accession number :
- 27121130
- Full Text :
- https://doi.org/10.1002/ccd.26555