Abstract

Assessment of cardiovascular technologists radiation exposure during percutaneous coronary intervention

Author(s): Thirumurugan E, Gomathi K, Swathy P, Syed Ali Afrin, Karpaga Pavithra, Sudesan J

Background: Percutaneous coronary intervention utilize an X-ray machine for visualization of coronary artery and it is considered as the major keystone in diagnosis of coronary artery disease. Cardiovascular technologists operate, maintain X-ray generating laboratory and they are susceptible to innumerable radiation dose. Minimizing radiation in the cardiac catheterization laboratory is important to prevent long term complications. To minimize the cardiovascular technologists radiation exposure without compromising the quality of PCI, deep understanding of factors which are associated with high radiation exposure is needed.

Objectives: The aim of the study was to correlate the cardiac technologists radiation exposure between standard projection and modified projections, comparison of the cardiac technologists radiation exposure between Magnification-15 and Magnification-20, Allura Xper FD-20 and Allura Xper FD-10 Cath Lab Systems and assessment of cardiac technologists radiation exposure between radial and femoral angioplasty.

Methods: In a study population of 101 patients aged >18 years old who undergone Percutaneous Coronary Intervention Technique for revascularization of high-grade coronary artery stenosis between January 2020 to January 2021, among which 72 (71.3%) were males and 29 (28.7%) were females. For those patients, procedural cardiac technologists radiation dose in respect with beam angulation are noted from digital pockect dosimeter by the single observer.

Results: In patients who underwent percutaneous coronary angioplasty, for those patients, we compared the standard projections with modified projections. Mean projection-specific dosimeter dose in modified-RAO 10 Cranial 40 views (0.20 ± 0.09) associated with reduced radiation exposure, when compared with standard-RAO 35 Cranial 35 views (3.83 ± 27.54). Then mean projection-specific dosimeter dose in modified-LAO 20 Caudal 40 views (0.06 ± 0.08) associated with reduced radiation exposure, when compared with standard-LAO 35 Caudal 35 views (0.20 ± 0.33). And then we compared the magnification-20 with magnification-15. Mean dosimeter dose in magnification-20 was 0.64 ± 0.61 vs. 0.54 ± 0.40 for magnification-15. Mean dosimeter dose in Philips Allura Xper FD-20 System was 0.82 ± 0.536 vs. 0.49 ± 0.38 for Philips Allura Xper FD-10 System. For radial angioplasty mean dosimeter dose was 0.55 ± 0.42 vs. 0.61 ± 0.48 for femoral angioplasty respectively.

Conclusion: In this study, we analysed few factors can be optimized to minimize radiation exposure in cath lab. We founded that modified projections is associated with low radiation exposure compared to standard projections. Allura Xper FD-10 Cath Lab system is associated with lower radiation compared to Allura Xper FD-20 Cath Lab System. Magnification-20 is associated with high radiation than Magnification-15. Femoral approach is associated with high radiation than radial angioplasty. Optimizing the factor which is discussed above, can potentially reduce radiation exposure to the technologists in cardiac cathlab.