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Methods to reduce patients' maximum skin dose during percutaneous coronary intervention for chronic total occlusion
Author(s) -
Suzuki Shigeru,
Furui Shigeru,
Isshiki Takaaki,
Kozuma Ken,
Koyama Yutaka,
Ochiai Masahiko,
Asakura Yasushi
Publication year - 2008
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21481
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , dose area product , percutaneous , fluoroscopy , nuclear medicine , radiology , surgery , cardiology , myocardial infarction
Objectives: The purpose of this research is to assess the patient's entrance skin dose (ESD) during percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), and discuss methods to reduce the maximum ESDs. Background: Only a few reports are available on the methods to reduce patients' maximum ESD during the procedures. Methods : This study included consecutive 30 patients who underwent PCI procedures for CTO in the three institutions. Pearson correlation test was employed to determine the relationship between total fluoroscopic time (TFT) and the maximum ESD, dose area product (DAP) value, and the maximum ESD in each institution. Results: There were significant correlations between the TFT and maximum ESD (Institution 1: P = 0.000410, Institution 2: P = 0.000525), and between the DAP and the maximum ESD (Institution 2: P < 0.0001). In Institution 1, TFT of 60 min was set as the upper limit, and the maximum ESDs were controlled within 7 Gy. In Institution 2, the angiographic unit was a biplane system, and two skin sites were exposed, corresponding to the angulation of each X‐ray tube. In Institution 3, the interventionalist changed the beam angulations frequently by several degrees during the procedures, and the maximum ESD was controlled within 3 Gy even during procedures with a TFT of more than 1 hr. Conclusions: The TFT and DAP, the latter of which is preferable, are useful to estimate the maximum ESD. Limiting the TFT or DAP, or changing the beam angulations is important to control ESD during prolonged procedures. © 2008 Wiley‐Liss, Inc.