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Radiation in the cath lab: Are patients really safe?
Session:
Posters (Sessão 3 - Écran 7) - Intervenção Coronária e Estrutural 1 - Vários
Speaker:
Hugo Costa
Congress:
CPC 2022
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Hugo Alex Costa; Teresa Faria da Mota; Raquel Fernandes; Miguel Espirito Santo; Hugo Palmeiro; Jimmy Martins; Daniela Carvalho; João Bispo; João Guedes; Hugo Vinhas; Ilídio Jesus
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"><strong>Introduction: </strong>Fluoroscopically guided interventional procedures have established new standarts in the clinical management of many diseases, and interventional cardiology has benefit with the advent of technology. Despite the benefits, the treatment of more complex coronary artery disease (CAD) <span style="background-color:white">may entail longer procedural times which translate to higher radiation exposure. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"><strong>Objective: </strong>Population characterization. <span style="background-color:white">To determine the radiation doses of patients who underwent PCI of complex CAD and set the diagnostic reference level (DRL) for this procedure in our Cath Lab, helping us to improve safe radiation practices<span style="color:#636d89">.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,"><strong>Methods:</strong> Retrospective study between 2019/2020, composed of n=289 patients that were submitted to complex PCI. DRLs were assessed as the round value of the 75th percentile (3rd quartile) of the distribution of the median dose values (air kerma-area product (KAP) and cumulative air kerma at the patient entrance reference point (K <sub>a,r</sub>)), and <span style="color:#292526">effective dose (ED) defined as ED=</span> <span style="color:#292526">0.18 x KAP.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"><strong>Results:</strong> A total of 297 patients were identified, with a mean age of 67.50 ± 11.26 years, 61.6% were female and 18.9% had obesity. 84.2% had multivessel disease, chronic total occlusions (CTO) in 59,6% and left main coronary artery disease (LMCA) in 40,4% of patients. Radial artery was the prefered access in 85,2% of cases. Total median percutaneous coronary Intervention (PCI) time was 119 mins with 34,6 mins of fluoroscopy time (FT) and 228,5 ml of contrast volume (CV) used. The median K <sub>a,r</sub> was 2064 mGy, KAP 112,15 Gy.Cm<sup>2</sup> and ED 20,68 mSv. A significant higher median PCI times, CV and radiation doses was seen in CTO patients. DRLs were access, with K <sub>a,r </sub>3219 mGy and KAP 173,24 Gy.Cm<sup>2</sup>.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"><strong>Conclusion: </strong>Local DRL for complex PCI was obtained, with K <sub>a,r </sub>3219 mGy and KAP 173,24 Gy.Cm<sup>2</sup>. We report a higher local DRLs compared to European registers, although data are scarce in complex PCI. These results are important to adapt radiation strategies that allow us to reduce exposure to patients and operators. </span></span></p>
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