Evolving operator practices reduced patient radiation dose in interventional cardiology: Trends in a single center - 03/03/25
, Jeffrey Moses, MD a, Kais Hyasat, MBBS a, b, Michael Collins, MD a, Ajay Kirtane, MD a, Margaret McEntegart, MD, PhD a, Leroy E Rabbani, MD a, Gasmelseed Y Ahmed, MD, PhD aHighlights |
• | A major overall reduction in both radiation and contrast use was observed over time. |
• | Similar trends were observed for 3 high volume operators. |
• | Similar trends were observed for 3 fluoroscopes in continuous service. |
• | Procedures using more than 5 gray declined from 7% to 0.8%. |
• | Changes in operator practices seem to be the major reason for these reductions. |
ABSTRACT |
Background |
This retrospective study addresses the role of operator and fluoroscopy equipment in reducing patient radiation exposure in the Cath lab.
Methods |
Data from 99,400 procedures performed in our institution between 2007 and 2019 were reviewed. Dosimetric parameters included reference point air kerma (Ka,r), Kerma Area Product (PKA), fluoroscopic time, and contrast volume. Results are characterized by their 50th and 99th percentiles. Data from a subset of fluoroscopes that were in continuous use and a subset of operators who used the same “continuous” fluoroscope in every year of the study were also analyzed.
Results |
For all procedures, median Ka,r declined by 63%, from 1.5 to 0.5Gy; 99th percentiles declined by 44%, from 8.6 to 4.8Gy. For the 3 “continuous fluoroscopes” median Ka,r declined by 60% from 1.6 to 0.6Gy; 99th percentile by 52% from 9.1 to 4.4Gy. The all-procedure median contrast volume declined by 53%, from 150 to 70ml; 99th percentile by 42% from 600 to 350ml. The all-procedure median fluoroscopy time declined by 2%; the 99th percentile increased by 32%. In the continuous subset, median fluoroscopy time declined by 20%; 99th percentile increased by 5%. For the operator's subset, the median Ka,r declined by 43% (P = .0362); the 99th percentile decreased by 22% (P = .0481). Substantial radiation dose procedures decreased from 7% to 0.8% of the procedure volume.
Conclusions |
There was a significant reduction in patient radiation (Ka,r and PKA) and contrast volume during the study period driven by systematic and operator practice changes.
Le texte complet de cet article est disponible en PDF.Abbreviations : PCI, Kar, PKA, FT, CV
Plan
Vol 283
P. 5-16 - mai 2025 Retour au numéro
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