Reduction of radiation exposure associated with renewal of the radiologic systems in coronary interventions
Copyright © 2018 Elsevier Masson SAS. All rights reserved..
PURPOSE: Interventional coronary procedures are an important source of radiation. This study sought to evaluate the effect of the renewal of the radiologic system on patient exposure during diagnostic coronary angiography (DCA) and percutaneous coronary interventions (PCIs).
METHODS: DCA and PCIs were obtained from three centres, which renewed their radiologic systems during their participation in the multicentre prospective observational RAY'ACT-2 study. Data were analysed from the months before and after the radiologic system was changed. The primary outcomes were the dose reduction estimated by the kerma.area product (KAP in Gy·cm2) and the ratio of the KAP to fluoroscopy time (Gy·cm2·min-1).
RESULTS: A total of 2148 patients underwent DCA (1575 before and 573 after the system change), and 1563 underwent PCI (1196 before and 367 after). A change in the radiologic system was associated with a KAP reduction of 43% for DCA (median [interquartile range]: 18.1Gy·cm2 [10.2-34.0] versus 31.5 [19.0-49.0], P<0.0001), and 38% for PCI (42.2Gy·cm2 [23.8-81.7] versus 70.1 [42.0-109.0], P<0.0001). Fluoroscopy time did not vary significantly, and the ratio KAP to fluoroscopy time significantly decreased by 54%. The dose reduction was homogeneous between the three centres and between different manufacturer's systems.
CONCLUSIONS: In this multicentre study, the renewal of the radiologic system was associated with a highly significant 40%-50% reduction in radiation dose, irrespective of the manufacturer. A close interaction between manufacturers and operators is needed to optimise the use of new equipment and the effectiveness of radiation reduction tools and techniques.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2018 |
|---|---|
| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:67 |
|---|---|
| Enthalten in: |
Annales de cardiologie et d'angeiologie - 67(2018), 5 vom: 01. Nov., Seite 334-338 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Georges, J-L [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 25.04.2019 Date Revised 25.04.2019 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.ancard.2018.08.002 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM289262704 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM289262704 | ||
| 003 | DE-627 | ||
| 005 | 20231225062151.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ancard.2018.08.002 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0964.xml |
| 035 | |a (DE-627)NLM289262704 | ||
| 035 | |a (NLM)30290910 | ||
| 035 | |a (PII)S0003-3928(18)30102-1 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Georges, J-L |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Reduction of radiation exposure associated with renewal of the radiologic systems in coronary interventions |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 25.04.2019 | ||
| 500 | |a Date Revised 25.04.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a PURPOSE: Interventional coronary procedures are an important source of radiation. This study sought to evaluate the effect of the renewal of the radiologic system on patient exposure during diagnostic coronary angiography (DCA) and percutaneous coronary interventions (PCIs) | ||
| 520 | |a METHODS: DCA and PCIs were obtained from three centres, which renewed their radiologic systems during their participation in the multicentre prospective observational RAY'ACT-2 study. Data were analysed from the months before and after the radiologic system was changed. The primary outcomes were the dose reduction estimated by the kerma.area product (KAP in Gy·cm2) and the ratio of the KAP to fluoroscopy time (Gy·cm2·min-1) | ||
| 520 | |a RESULTS: A total of 2148 patients underwent DCA (1575 before and 573 after the system change), and 1563 underwent PCI (1196 before and 367 after). A change in the radiologic system was associated with a KAP reduction of 43% for DCA (median [interquartile range]: 18.1Gy·cm2 [10.2-34.0] versus 31.5 [19.0-49.0], P<0.0001), and 38% for PCI (42.2Gy·cm2 [23.8-81.7] versus 70.1 [42.0-109.0], P<0.0001). Fluoroscopy time did not vary significantly, and the ratio KAP to fluoroscopy time significantly decreased by 54%. The dose reduction was homogeneous between the three centres and between different manufacturer's systems | ||
| 520 | |a CONCLUSIONS: In this multicentre study, the renewal of the radiologic system was associated with a highly significant 40%-50% reduction in radiation dose, irrespective of the manufacturer. A close interaction between manufacturers and operators is needed to optimise the use of new equipment and the effectiveness of radiation reduction tools and techniques | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Angiographic systems | |
| 650 | 4 | |a Angioplastie coronaire percutanée | |
| 650 | 4 | |a Coronarographie | |
| 650 | 4 | |a Coronary angiography | |
| 650 | 4 | |a Kerma | |
| 650 | 4 | |a Kerma area product | |
| 650 | 4 | |a Percutaneous coronary intervention | |
| 650 | 4 | |a Produit dose surface | |
| 650 | 4 | |a Radiation protection | |
| 650 | 4 | |a Radioprotection | |
| 650 | 4 | |a Équipement angiographique | |
| 700 | 1 | |a Boueri, Z |e verfasserin |4 aut | |
| 700 | 1 | |a Mailler, B |e verfasserin |4 aut | |
| 700 | 1 | |a Nallet, O |e verfasserin |4 aut | |
| 700 | 1 | |a Millischer, D |e verfasserin |4 aut | |
| 700 | 1 | |a Faure, A |e verfasserin |4 aut | |
| 700 | 1 | |a Massiani, P F |e verfasserin |4 aut | |
| 700 | 1 | |a Belle, L |e verfasserin |4 aut | |
| 700 | 1 | |a Chapoutot, L |e verfasserin |4 aut | |
| 700 | 1 | |a Girodet, B |e verfasserin |4 aut | |
| 700 | 1 | |a Cattan, S |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Annales de cardiologie et d'angeiologie |d 1968 |g 67(2018), 5 vom: 01. Nov., Seite 334-338 |w (DE-627)NLM000057096 |x 1768-3181 |7 nnns |
| 773 | 1 | 8 | |g volume:67 |g year:2018 |g number:5 |g day:01 |g month:11 |g pages:334-338 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ancard.2018.08.002 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 67 |j 2018 |e 5 |b 01 |c 11 |h 334-338 | ||