Investigation of factors affecting dose-area product during single-vessel percutaneous coronary intervention at the General Hospital of Ioannina “CHATZIKOSTA”

Introduction: To process and analyze radiation exposure data from a patient population that underwent single-vessel percutaneous coronary interventions.

Materials and Methods: Dose-area product, fluoroscopy time and number of cineangiography frames were retrospectively collected from 289 patients between January 8, 2021 and February 20, 2023, and their medians were compared with the established national and international diagnostic reference levels. Several patient-, disease-, and procedure-related variables were analyzed in a multiple linear regression statistical model with a dose-area product as the primary endpoint.

Results: The present dose-area product data exceeded most of the proposed diagnostic reference levels (1.8 to 3.0 times higher than the updated European benchmarks), while the opposite trend was observed for fluoroscopy time and cineangiography frames. Through multivariate analysis, each 5 units increase in body mass index led to a 1.17-fold change in dose-area product (95% confidence interval: 1.13 to 1.20); female dose-area product was lower than male (0.83, 95% confidence interval: 0.78 to 0.89); elective (vs ad-hoc) procedures were associated with a decrease in dose-area product (0.88, 95% confidence interval: 0.82 to 0.95); treating complex (vs simple) lesions increased dose-area product by a factor of 1.15 (95% confidence interval: 1.07 to 1.24); each two minute rise in fluoroscopy time conferred a 1.08-fold change in dose-air product (95% confidence interval: 1.07 to 1.09).

Conclusions: Elevated dose-area product underscores the need for investigation. Multivariate analysis demonstrated that higher bone-mass index, male gender, procedural complexity, ad-hoc percutaneous coronary interventions and fluoroscopy time were associated with the highest increase in dose-area product.