Safety and efficacy of an ultra low dose fluoroscopic protocol for chronic total occlusion recanalization.
X-ray
chronic total occlusion
coronary artery disease
fluoroscopy
percutaneous coronary intervention
radiation exposure
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
revised:
02
02
2023
received:
25
11
2022
accepted:
16
02
2023
medline:
11
4
2023
pubmed:
2
3
2023
entrez:
1
3
2023
Statut:
ppublish
Résumé
Chronic total occlusion (CTO) revascularization is a major source of radiation for both patients and physicians. Therefore, efforts to minimize radiation during CTO percutaneous coronary intervention (PCI) are highly encouraged. To evaluate the impact of an Ultra Low fluoroscopic Dose Protocol (ULDP), based on 3.75 frames per second for the fluoroscopy and 7.5 frames per second for the cine acquisition, during CTO PCI. One hundred fifty consecutive patients who underwent CTO PCI were retrospectively enrolled. Eighty-five underwent standard dose protocol (SDP) and 65 ULDP. Radiation exposure and acute clinical outcomes were compared between groups. Results were stratified according to lesion complexity. Patients undergoing ULDP, as compared to those undergoing SDP, showed a significant reduction of kerma area product, both for simple lesions (6861.0 vs. 13236.0 mGy × cm ULDP significantly reduces radiation exposure in the setting of high complexity procedures such as CTO PCI. This reduction seemed to be greater with increased procedural complexity and did not impact acute success or adverse clinical events.
Sections du résumé
BACKGROUND
Chronic total occlusion (CTO) revascularization is a major source of radiation for both patients and physicians. Therefore, efforts to minimize radiation during CTO percutaneous coronary intervention (PCI) are highly encouraged.
AIMS
To evaluate the impact of an Ultra Low fluoroscopic Dose Protocol (ULDP), based on 3.75 frames per second for the fluoroscopy and 7.5 frames per second for the cine acquisition, during CTO PCI.
METHODS
One hundred fifty consecutive patients who underwent CTO PCI were retrospectively enrolled. Eighty-five underwent standard dose protocol (SDP) and 65 ULDP. Radiation exposure and acute clinical outcomes were compared between groups. Results were stratified according to lesion complexity.
RESULTS
Patients undergoing ULDP, as compared to those undergoing SDP, showed a significant reduction of kerma area product, both for simple lesions (6861.0 vs. 13236.0 mGy × cm
CONCLUSIONS
ULDP significantly reduces radiation exposure in the setting of high complexity procedures such as CTO PCI. This reduction seemed to be greater with increased procedural complexity and did not impact acute success or adverse clinical events.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
911-917Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.
Références
Mettler FA, Huda Jr, W, Yoshizumi TT, et al. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology. 2008;248(1):254-263.
Andreassi MG, Cioppa A, Botto N, et al. Somatic DNA damage in interventional cardiologists: a case-control study. FASEB J. 2005;19:998-999.
Roguin A, Goldstein J, Bar O. Brain tumours among interventional cardiologists: a cause for alarm? Report of four new cases from two cities and a review of the literature. EuroIntervention. 2012;7(9):1081-1086.
Wambersie A, DeLuca PM, Zoetelief J, ICRU. Preface. J ICRU. 2005;5:1-2.
Suzuki S, Furui S, Kohtake H, et al. Radiation exposure to patient's skin during percutaneous coronary intervention for various lesions, including chronic total occlusion. Circ J. 2006;70:44-48.
Maccagni D, Godino C, Latib A, et al. Analysis of a low dose protocol to reduce patient radiation exposure during percutaneous coronary interventions. Am J Cardiol. 2017;119(2):203-209.
Fu MH, Pan YY, Tao XF, Du J, Cheng B. Safety and efficacy of a low frame rate protocol for percutaneous coronary intervention for chronic total occlusions. Chin Med J. 2021;134(10):1215-1217.