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Maccagni, Davide, R.T; Godino, Cosmo, M.D; Latib, Azeem, M.D; Azzalini, Lorenzo, M.D. Ph.D. M.Sc; Pazzanese, Vittorio, M.D; Chieffo, Alaide, M.D; Margonato, Alberto, M.D; Colombo, Antonio, M.D
The American journal of cardiology, 01/2017, Volume: 119, Issue: 2Journal Article
Abstract The cardiac catheterization laboratory is an important source of radiation for patients and operators and it is good practice to limit exposure as much as possible. The purpose of this study was to evaluate the effectiveness and impact of a radiological Low Dose Protocol (LDP) in terms of reduction in patient radiation exposure during percutaneous coronary interventions (PCI). Between November 2014 and October 2015, 906 consecutive patients who underwent PCI were evaluated. Of these, 571 patients (63%) were treated with the Standard Dose Protocol (SDP) of 15 frames per second (fps) for cine acquisition and standard settings for fluoroscopy, and 335 patients (37%) with the LDP of 7.5 fps for cine acquisition and low dose settings for fluoroscopy. In the LDP group, we observed a significant reduction of Kerma Area Product (53.3 LDP vs 115 SDP Gycm2 , p<0.0001 and Air Kerma at Interventional Reference Point (AK at IRP) (0.79 LDP vs 1.976 SDP Gy, p<0.0001). Marked differences were observed regarding the exceeding of International Commission on Radiological Protection and National Council on Radiation Protection and Measurements’ AK at IRP trigger level (cut-off for potential skin injuries), which were significantly lower in the LDP group (1.8 vs 7.2 %, p<0.0001). Such difference was more relevant in complex PCI. In conclusion, the implementation of LDP allowed a marked reduction in patient dosimetric parameters for PCI and significantly reduced the risk of exceeding the ICRP/NCRP trigger levels for potential skin injuries.
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