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  5. Ten Years of Interventional Cardiology Catheterization Therapy Procedures in a Large Territory Hospital. A Retrospective Analysis of High Maximum Patient Skin Doses to Evaluate Trends

Ten Years of Interventional Cardiology Catheterization Therapy Procedures in a Large Territory Hospital. A Retrospective Analysis of High Maximum Patient Skin Doses to Evaluate Trends

V Chatonidis1, V Tsapaki2*, P Karaiskos1, E Pantelis1, S Patsilinakos2, S Kottou1, (1) National and Kapodistrian University of Athens, Faculty of Medicine, Medical Physics Laboratory, Athens, Greece, (2) Konstantopoulio General Hospital, Nea Ionia, Athens, Greece

Presentations

(Monday, 7/15/2019) 3:45 PM - 4:15 PM

Room: Exhibit Hall | Forum 8

Purpose: To investigate the frequency of patients exposed to more than 2Gy radiation dose when undergoing percutaneous coronary interventions (PCI) within 10-year period in a busy large territory hospital.

Methods: All PCI patient records within ten years (2009-2018) were queried. The investigation focused on high cumulative dose values (calibrated in terms of cumulative patient entrance surface dose – peak skin dose-PSD) and other dose metrics extracted from image-guided therapy system’s radiation dose structured report (RSDR). Dose data were distributed in three bands: bands A (between 2 and 3Gy) and B (between 3 and 5Gy) consist two notification thresholds, whereas band C included doses over 5Gy and was identified as trigger threshold.

Results: The two main interventional cardiologists involved remained the same during the decade, conducting the majority of interventions. Statistical analysis of these bands indicated that during 4264 PCI procedures, annually, 15-25% of patients were exposed to 2-3Gy, 11-20% to 3-5Gy and 1-7% to more than 5Gy. Incidents exceeding 2Gy found to be annually 34-47% of total PCI procedures. Comparing the outcome of first two with the last two years, an increase in PCI incidents of 57% was noticed, with complex operations rising high dose incidents by 37% and mean procedure duration time by 34% (from 16 to 21.5 min). Each year in this department 8 to 44 patients underwent PCI more than once (2-12% respectively). However, we ought to clarify that, although PSD was high, no adverse effects have been detected so far.

Conclusion: This work strongly indicates the need of unceasing radiation dose monitoring in interventional cardiology catheterization room as well as careful patient medical follow-up when needed, in accordance with international guidelines, as incidents with patient skin dose exceeding 2 and 5Gy can reach up to 47% and 7% of the annual number of PCI procedures respectively.

Keywords

Angioplasty, Fluoroscopy, Radiation Dosimetry

Taxonomy

IM- Radiation dose and risk: General (Most Aspects)

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