Patient Radiation Dosage During Lower Extremity Endovascular Intervention.


Journal

JACC. Cardiovascular interventions
ISSN: 1876-7605
Titre abrégé: JACC Cardiovasc Interv
Pays: United States
ID NLM: 101467004

Informations de publication

Date de publication:
11 03 2019
Historique:
received: 18 09 2018
revised: 22 10 2018
accepted: 06 11 2018
entrez: 9 3 2019
pubmed: 9 3 2019
medline: 6 5 2020
Statut: ppublish

Résumé

The aims of this study were to determine the incidence of actionably high radiation dosages and to identify predictors of increased patient dosage. Peripheral endovascular intervention using fluoroscopic imaging has become a mainstay of treatment for lower extremity peripheral artery disease but exposes patients to ionizing radiation. Patient radiation dosage, quantified as dose-area product (DAP), was obtained from the National Cardiovascular Data Registry Peripheral Vascular Intervention Registry. The percentage of procedures exceeding a DAP of 500 Gy · cm Among 17,174 procedures performed at 73 sites, patient DAP exceeded 500 Gy · cm Radiation dosage with the potential for tissue injury occurs in 1 of every 14 patients undergoing lower extremity endovascular interventions, and all such patients are exposed to the potential for subsequent malignancy. Pre-procedural assessment of patients' risk for elevated radiation dosage may allow targeted use of radiation mitigation strategies in patients at increased risk for elevated exposure.

Sections du résumé

OBJECTIVES
The aims of this study were to determine the incidence of actionably high radiation dosages and to identify predictors of increased patient dosage.
BACKGROUND
Peripheral endovascular intervention using fluoroscopic imaging has become a mainstay of treatment for lower extremity peripheral artery disease but exposes patients to ionizing radiation.
METHODS
Patient radiation dosage, quantified as dose-area product (DAP), was obtained from the National Cardiovascular Data Registry Peripheral Vascular Intervention Registry. The percentage of procedures exceeding a DAP of 500 Gy · cm
RESULTS
Among 17,174 procedures performed at 73 sites, patient DAP exceeded 500 Gy · cm
CONCLUSIONS
Radiation dosage with the potential for tissue injury occurs in 1 of every 14 patients undergoing lower extremity endovascular interventions, and all such patients are exposed to the potential for subsequent malignancy. Pre-procedural assessment of patients' risk for elevated radiation dosage may allow targeted use of radiation mitigation strategies in patients at increased risk for elevated exposure.

Identifiants

pubmed: 30846087
pii: S1936-8798(18)32293-3
doi: 10.1016/j.jcin.2018.11.005
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

473-480

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Auteurs

Andrew M Goldsweig (AM)

Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska.

Kevin F Kennedy (KF)

Department of Cardiovascular Research, St. Luke's Mid America Heart Institute, Kansas City, Missouri.

J Dawn Abbott (JD)

Division of Cardiovascular Medicine, Warren Alpert Medical School of Brown University and Lifespan Cardiovascular Institute, Providence, Rhode Island.

W Schuyler Jones (WS)

Duke Clinical Research Institute and Division of Cardiovascular Medicine, Duke University, Durham, North Carolina.

Poonam Velagapudi (P)

Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska.

Frank J Rutar (FJ)

Department of Radiation Safety, University of Nebraska Medical Center, Omaha, Nebraska.

Jeptha C Curtis (JC)

Yale New Haven Hospital Center for Outcomes Research and Evaluation and Section of Cardiovascular Medicine, Yale University, New Haven, Connecticut.

Thomas T Tsai (TT)

Division of Cardiovascular Medicine, University of Colorado and Kaiser Permanente Colorado, Denver, Colorado.

Herbert D Aronow (HD)

Division of Cardiovascular Medicine, Warren Alpert Medical School of Brown University and Lifespan Cardiovascular Institute, Providence, Rhode Island. Electronic address: herbert.aronow@lifespan.org.

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Classifications MeSH