Investigation of factors affecting dose-area product during single-vessel percutaneous coronary intervention at the General Hospital of Ioannina “CHATZIKOSTA”
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Siiskonen T, Ciraj-Bjelac O, Dabinc J, et al. Establishing the European diagnostic reference levels for interventional cardiology. Phys Med. 2018;54:42-48. https://doi.org/10.1016/j.ejmp.2018.09.012Search in Google Scholar
Ho TL, Shieh SH, Lin CL, Shen WC, Kao CH. Risk of cancer among cardiologists who frequently perform percutaneous coronary interventions: a population-based study. Eur J Clin Invest. 2016;46:527-534. https://doi.org/10.1111/eci.12628Search in Google Scholar
Purohit E, Karimipour D, Madder RD. Multiple cutaneous cancers in an interventional cardiologist: Predominance in unprotected skin nearest the radiation source. Cardiovasc Revasc Med. 2021;28:206-207. https://doi.org/10.1016/j.carrev.2021.01.029Search in Google Scholar
Srimahachota S, Udayachalerm W, Kupharang T, et al. Radiation skin injury caused by percutaneous coronary intervention, report of 3 cases. Int J Cardiol. 2012;154:e31-e33. https://doi.org/10.1016/j.ijcard.2011.05.016Search in Google Scholar
Lai CC, Wei KC, Chen WY, et al. Risk Factors For Radiation-Induced Skin Ulceration in Percutaneous Coronary Interventions of Chronic Total Occluded Lesions: A 2-Year Observational Study. Sci Rep. 2017;7:8408. https://doi.org/10.1038/s41598-017-08945-4Search in Google Scholar
Tseng YT, Yu YC, Cheng IN, et al. Percutaneous Coronary Intervention-Related Radiation Ulcer: Diagnosis, Management, and Prevention Strategy. Acta Cardiol Sin. 2023;39:480-487. https://doi.org/10.6515/acs.202305_39(3).20221219aSearch in Google Scholar
ICRP 2017. Diagnostic reference levels in medical imaging. ICRP Publication 135. Ann ICRP 46(1). https://doi.org/10.1177/0146645317717209Search in Google Scholar
Aroua A, Rickli H, Stauffer JC, et al. How to set up and apply reference levels in fluoroscopy at a national level. Eur Radiol. 2007;17:1621-1633. https://doi.org/10.1007/s00330-006-0463-3Search in Google Scholar
Bogaert E, Bacher K, Lemmens K, et al. A large-scale multicentre study of patient skin doses in interventional cardiology: dose-area product action levels and dose reference levels. Br J Radiol. 2009;82:303-312. https://doi.org/10.1259/bjr/29449648Search in Google Scholar
Hart D, Hillier MC, Wall BF. National reference doses for common radiographic, fluoroscopic and dental X-ray examinations in the UK. Br J Radiol. 2009;82: 1-12. https://doi.org/10.1259/bjr/12568539Search in Google Scholar
Brnić Z, Krpan T, Faj D, et al. Patient radiation doses in the most common interventional cardiology procedures in Croatia: first results. Radiat Prot Dosim. 2010;138:180-186. https://doi.org/10.1093/rpd/ncp237Search in Google Scholar
Miller DL, Hilohi CM, Spelic DC. Patient radiation doses in interventional cardiology in the U.S.: Advisory data sets and possible initial values for U.S. reference levels. Med Phys. 2012;39:6276-6286. https://doi.org/10.1118/1.4754300Search in Google Scholar
Zotova R, Vassileva J, Hristova J, Pirinen M, Järvinen H. A national patient dose survey and setting of reference levels for interventional radiology in Bulgaria. Eur Radiol. 2012;22:1240-1249. https://doi.org/10.1007/s00330-012-2386-5Search in Google Scholar
Simantirakis G, Koukorava C, Kalathaki M, et al. Reference levels and patient doses in interventional cardiology procedures in Greece. Eur Radiol. 2013;23:2324-2332. https://doi.org/10.1007/s00330-013-2813-2Search in Google Scholar
Crowhurst JA, Whitby M, Thiele D, et al. Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals. J Med Radiat Sci. 2014;61:135-141. https://doi.org/10.1002/jmrs.67Search in Google Scholar
Säteilyturvakeskus (STUK) Päätös 15/3020/2016. Potilaan säteilyaltistuksen vertailutasot kardiologisessa radiologiassa. Helsinki, Finland, 2016; http://www.stuk.fi/documents/88234/1106801/Decision-15-3020-2015-Reference-levels-for-the-patientsradiation-exposure-20122016.pdf/18940d29-67bb-eb75-66ae-ae037b699779 [retrieved January 22, 2018].Search in Google Scholar
Georges JL, Belle L, Etard C, et al. Radiation Doses to Patients in Interventional Coronary Procedures—Estimation of Updated National Reference Levels by Dose Audit. Radiat Prot Dosim. 2017;175:17-25. https://doi.org/10.1093/rpd/ncw261Search in Google Scholar
Widmark A. Technical Report: Diagnostic reference level (DRL) in Norway 2017. Results, revision and establishment of new DRL. NRPA Report 2018:3. Norwegian Radiation Protection Authority. Østerås 2018; https://doi.org/10.13140/RG.2.2.29964.21120Search in Google Scholar
Kim JS, Lee BK, Ryu DR, et al. A multicentre survey of local diagnostic reference levels and achievable dose for coronary angiography and percutaneous transluminal coronary intervention procedures in Korea. Radiat Prot Dosim. 2019;187:378-382. https://doi.org/10.1093/rpd/ncz178Search in Google Scholar
Schegerer A, Loose R, Heuser LJ, Brix G. Diagnostic Reference Levels for Diagnostic and Interventional X-Ray Procedures in Germany: Update and Handling. Fortschr Röntgenstr. 2019;191:739-751. https://doi.org/10.1055/a-0824-7603Search in Google Scholar
Pace E, Cortis K, Debono J, Grech M, Caruana CJ. Establishing local and national diagnostic and interventional cardiology and radiology reference levels in a small European state: the case of Malta. Radiat Prot Dosim. 2020;191:261-271. https://doi.org/10.1093/rpd/ncaa152Search in Google Scholar
Sánchez R, Vañó E, Fernández Soto JM, et al. Updating national diagnostic reference levels for interventional cardiology and methodological aspects. Phys Med. 2020;70:169-175. https://doi.org/10.1016/j.ejmp.2020.01.014Search in Google Scholar
Subban V, Amelot S, Victor SM, et al. Radiation doses during cardiac catheterisation procedures in India: a multicentre study. Asia Intervention. 2020;6: 25-33. https://doi.org/10.4244/AIJ-D-18-00044Search in Google Scholar
Yap EML, Magno LP, Macaraeg CA, et al. Radiation dose in coronary angiography and percutaneous coronary intervention: Establishment of diagnostic reference levels at the Philippine Heart Center. Interv Cardiol Rev. 2021;16:e13. https://doi.org/10.15420/icr.2021.16.PO2Search in Google Scholar
Health Information and Quality Authority (HIQA). Diagnostic Reference Levels: Guidance on the establishment, use and review of diagnostic reference levels for medical exposure to ionising radiation. Updated October 2022; https://www.hiqa.ie/sites/default/files/202211/Diagnostic%20Reference%20Levels_Undertaking%20guidance_Oct%202022.pdfSearch in Google Scholar
Srimahachota S, Krisanachinda A, Roongsangmanoon W, et al. Establishment of national diagnostic reference levels for percutaneous coronary interventions (PCIs) in Thailand. Phys Med. 2022;96:46-53. https://doi.org/10.1016/j.ejmp.2022.02.013Search in Google Scholar
Smith IR, Rivers JT. Measures of Radiation Exposure in Cardiac Imaging and the Impact of Case Complexity. Heart Lung Circ. 2008;17:224-231. https://doi.org/10.1016/j.hlc.2007.10.004Search in Google Scholar
Miller DL, Balter S, Wagner LK, et al. Quality improvement guidelines for recording patient radiation dose in the medical record. J Vasc Interv Radiol. 2004;15:423-429. https://doi.org/10.1097/01.RVI.0000126814.97605.C6Search in Google Scholar
Larrazet F, Dibie A, Philippe F, Palau R, Klausz R, Laborde F. Factors influencing fluoroscopy time and dose-area product values during ad hoc one-vessel percutaneous coronary angioplasty. Brit J Radiol. 2003;76:473-477. https://doi.org/10.1259/bjr/21553230Search in Google Scholar
Kuipers G, Delewi R, Velders XL, et al. Radiation Exposure During Percutaneous Coronary Interventions and Coronary Angiograms Performed by the Radial Compared With the Femoral Route. J Am Coll Cardiol Intv. 2012;5:752-757. https://doi.org/10.1016/j.jcin.2012.03.020Search in Google Scholar
Delewi R, Hoebers LP, Remunddal T, et al. Clinical and Procedural Characteristics Associated With Higher Radiation Exposure During Percutaneous Coronary Interventions and Coronary Angiography. Circ Cardiovasc Interv. 2013;6:501-506. https://doi.org/10.1161/CIRCINTERVENTIONS.113.000220Search in Google Scholar
Faroux L, Blanpain T, Nazeyrollas P, et al. Trends in Patient Exposure to Radiation in Percutaneous Coronary Interventions Over a 10-Year Period. Am J Cardiol. 2017;120:927-930. https://doi.org/10.1016/j.amjcard.2017.06.021Search in Google Scholar
Zanca F, Collard C, Alexandre N, et al. Patient exposure data and operator dose in coronary interventional procedures: Impact of body-mass index and procedure complexity. Phys Med. 2020;76:38-43. https://doi.org/10.1016/j.ejmp.2020.05.006Search in Google Scholar
Koh Y, Vogrin S, Noaman S, et al. Effect of Different Anthropometric Body Indexes on Radiation Exposure in Patients Undergoing Cardiac Catheterisation and Percutaneous Coronary Intervention. Tomography. 2022;8:2256-2267. https://doi.org/10.3390/tomography8050189Search in Google Scholar
Stocker TJ, Abdel-Wahab M, Möllmann H, et al. Trends and predictors of radiation exposure in percutaneous coronary intervention: the PROTECTION VIII study. EuroIntervention. 2022;18:e324-e332. https://doi.org/10.4244/EIJ-D-21-00856Search in Google Scholar
Bernardi G, Padovani R, Morocutti G, et al. Clinical and Technical Determinants of the Complexity of Percutaneous Transluminal Coronary Angioplasty Procedures: Analysis in Relation to Radiation Exposure Parameters. Catheter Cardiovasc Interv. 2000;51:1-9. https://doi.org/10.1002/1522-726X(200009)51:1<1::AID-CCD1>3.0.CO;2-KSearch in Google Scholar
Balter S, Miller DL, Vano E, et al. A pilot study exploring the possibility of establishing guidance levels in x-ray directed interventional procedures. Med Phys. 2008;35:673-680. https://doi.org/10.1118/1.2829868Search in Google Scholar
Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for percutaneous transluminal coronaryangioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation. 1988;78:486-502. https://doi.org/10.1161/01.CIR.78.2.486Search in Google Scholar
Fetterly KA, Lennon RJ, Bell MR, Holmes DR Jr, Rihal CS. Clinical determinants of radiation dose in percutaneous coronary interventional procedures: influence of patient size, procedure complexity, and performing physician. JACC Cardiovasc Interv. 2011;4:336-343. https://doi.org/10.1016/j.jcin.2010.10.014Search in Google Scholar
Jarvinen H, Farah J, Siiskonen T, et al. Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures. Phys Med. 2018;46:67-74. https://doi.org/10.1016/j.ejmp.2018.01.010Search in Google Scholar
Neill J, Douglas H, Richardson G, et al. Comparison of Radiation Dose and the Effect of Operator Experience in Femoral and Radial Arterial Access for Coronary Procedures. Am J Cardiol. 2010;106:936-940. https://doi.org/10.1016/j.amjcard.2010.06.002Search in Google Scholar
Verdoia M, Pipan P, Viola O, et al. Impact of Different Measures of Body Size on the Radiation Dose During Coronary Angiography and Percutaneous Coronary Intervention: Results from a Large Single Center Cohort. Angiology. 2022;73:478-484. https://doi.org/10.1177/00033197211053133Search in Google Scholar
Saunamaki KI. Radiation protection in the cardiac catheterization laboratory: special focus on the role of the operator. Interv Cardiol. 2010;2:667-672. https://doi.org/10.2217/ica.10.63Search in Google Scholar
Sadick V, Reed W, Collins L, Sadick N, Heard R, Robinson J. Impact of biplane versus single-plane imaging on radiation dose, contrast load and procedural time in coronary angioplasty. Brit J Radiol. 2010;83:379-393. https://doi.org/10.1259/bjr/21696839Search in Google Scholar
Georges JL, Livarek B, Gibault-Genty G, et al.Reduction of radiation delivered to patients undergoing invasive coronary procedures. Effect of a programme for dose reduction based on radiation-protection training. Arch Cardiovasc Dis. 2009;102:821-827. https://doi.org/10.1016/j.acvd.2009.09.007Search in Google Scholar
Roongsangmanoon W, Srimahachota S, Krisanachinda A, Rehani M. Radiation doses to patients in coronary interventions in a hospital in Thailand. Asian Biomed. 2012;6:565-571.Search in Google Scholar
Fazel R, Curtis J, Wang Y, et al. Determinants of Fluoroscopy Time for Invasive Coronary Angiography and Percutaneous Coronary Intervention: Insights from the NCDR®. Catheter Cardiovasc Interv. 2013;82:1091-1105. https://doi.org/10.1002/ccd.24996Search in Google Scholar
Nikolsky E, Pucelikova T, Mehran R, et al. An evaluation of fluoroscopy time and correlation with outcomes after percutaneous coronary intervention. J Invasive Cardiol. 2007;19:208-213.Search in Google Scholar
Chon MK, Chun KJ, Lee DS, et al. Radiation reduction during percutaneous coronary intervention: A new protocol with a low frame rate and selective fluoroscopic image storage. Medicine. 2017;96:30(e7517). https://doi.org/10.1097/MD.0000000000007517Search in Google Scholar
Bousis C, Kosovitsas T, Karanikis P, Kotsia A, Tzima E, Pappa E. Dose area product reduction through a practice implementing low frame rate fluoroscopy and increased collimation during single vessel percutaneous coronary interventions. Radiat Prot Environ. 2024; 47:121-128. https://doi.org/10.4103/rpe.rpe_13_24Search in Google Scholar
Boland JE, Wang LW, Love BJ, Wynne DG, Muller DWM. Radiation dose during percutaneous treatment of structural heart disease. Heart Lung Circ. 2014;23:1075-83. https://doi.org/10.1016/j.hlc.2014.04.258Search in Google Scholar
Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. Am Heart J. 2009;157:132-140. https://doi.org/10.1016/j.ahj.2008.08.023Search in Google Scholar
Delichas MG, Psarrakos K, Hadjiioannou K, et al. The dependence of patient dose on factors relating to the technique and complexity of Interventional Cardiology procedures. Phys Med. 2005;21:153-157. https://doi.org/10.1016/S1120-1797(05)80004-3Search in Google Scholar
Üreyen CM, Coşansu K, Vural MG, et al. Is trans-radial approach related to an increased risk of radiation exposure in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention? (The SAKARYA study). Anatol J Cardiol. 2019;22:5-12. https://doi.org/10.14744/AnatolJCardiol.2019.06013Search in Google Scholar