Chronic Radiodermatitis Following Cardiac Catheterization

Lichtenstein, Daniel A.; Klapholz, Laurent; Vardy, Daniel; Leichter, Israel; Mosseri, Maurice; Klaus, Sydney N.; Gilead, Leon

doi:10.1001/archderm.1996.03890300085012

Cited by 104 publications

(49 citation statements)

References 12 publications

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“…Several studies have investigated the radiation doses received by doctors and patients during coronary angiography and angioplasty and the radiation risks encountered in such procedures [1][2][3][4][5][6][7][8][9]. Most of these studies were retrospective analyses; they have been conducted without the benefit of modern X-ray equipment and protection, and results have not been consistent.…”

Section: Introductionmentioning

confidence: 99%

“…Most of these studies were retrospective analyses; they have been conducted without the benefit of modern X-ray equipment and protection, and results have not been consistent. Recently, there has been serious concern in relation to the radiation injury to skin following prolonged catheterization procedures [8,9]. These important issues need clarification, particularly since most of the results available have been derived from studies conducted in the prestent era.…”

Section: Introductionmentioning

confidence: 99%

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Radiation exposure of patients and coronary arteries in the stent era: A prospective study

Katritsis

Efstathopoulos

Betsou

et al. 2000

Cathet. Cardiovasc. Intervent.

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Previous studies have investigated the radiation dose to doctors and patients during coronary angiography and angioplasty, but most of them were retrospective, conducted in the prestent era, and results have not been consistent. Effective dose of 57 patients undergoing coronary angiography and/or angioplasty was assessed by using a dose-area product (DAP) to effective dose conversion factor. Radiation exposure risks to patients were then calculated for each procedure. Thermoluminescent dosimeters, mounted on a specially designed catheter that was advanced to the left or right sinus of Valsalva, were used to measure the dose received by the coronary arteries. Mean effective dose received by patients were 5.0 +/- 0.5 mSv for coronary angiography, 6.6 +/- 1.0 mSv for angioplasty, 10.2 +/- 1.5 mSv for angioplasty followed by stent implantation, 13.6 +/- 2.5 mSv for angiography followed by ad hoc angioplasty, and 16.7 +/- 2.8 mSv for angiography followed by ad hoc angioplasty and stent implantation. Patient risk of developing cancer after each procedure was 0.025%, 0.033%, 0.051%, 0.068%, and 0.084%, respectively. Corresponding mean coronary irradiation doses were 24 +/- 2.5, 31.0 +/- 3.6, 43.6 +/- 7.2, 55.0 +/- 7.5, and 64.7 +/- 5.6 mGy, respectively. A linear relationship of the DAP and the dose at the coronary arteries was found: DAP = 1,273 (cm(2)) x coronary dose (mGy). Radiation exposure to coronary arteries and associated risk to patients are relatively low, even following complicated, multivessel angioplasty with stent implantation. Our method can be used for calculation of radiation risk to patients and radiation dose to coronary arteries by using external dosimeters. Cathet. Cardiovasc. Intervent. 51:259-264, 2000.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radiation exposure of patients and coronary arteries in the stent era: A prospective study

Katritsis

Efstathopoulos

Betsou

et al. 2000

Cathet. Cardiovasc. Intervent.

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“…The majority of instances reported in the literature or to the United States Food and Drug Administration (FDA) result from cardiac radiofrequency ablation or coronary angioplasty [3,6]. Some reported skin injuries were associated with transjugular intrahepatic portosystemic shunt (TIPS) creation, renal angioplasty, multiple hepatic/biliary procedures, or embolization [1,3,[6][7][8][9]. In all patients the risk of a cancer from the exposure is not a major concern when compared to the benefits of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure of Medical Staff in Interventional Radiology

Kara

Akkurt

2016

Acta Phys. Pol. A

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The aim of this study was to assess the radiation dose received by doctors, nurses, X-ray technician medical staff during cardiac catheterization in a representative sample of the staff in our angiography department. Radiation from X-ray machines can cause serious side effects. Radiation exposure of angiography staff (doctors, nurses, medical staff and X-ray technicians) has been recognized as a necessary hazard in angiography department. The purpose of our work is to determine angiography staff radiation doses during interventional radiology, to identify procedures associated with higher radiation doses, and to determine the effects of various parameters on staff doses. This study was performed at Suleyman Demirel University Medical Faculty Hospital. The procedure of study was performed in an interventional radiology department. We have recorded radiation doses data during all related imaging procedures performed as a part of department activity. The distances from the X-ray tube were 0 cm (doctor), 60 cm (nurse), 120 cm (medical staff) and 180 cm (X-ray technician). It is important to understand the radiation effects on medical staff in interventional radiology procedures. Determinants of radiation risk include not only radiation dose levels but also medical staff number, ages, gender and their position. These factors can increase or decrease the risk of exposure.

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“…Although several reports have been published describing clinically significant radiation-induced skin lesions following radiofrequency catheter ablations or PTCA [1][2][3][4][5], precise information regarding doses delivered during such procedures is rarely provided. The on-line availability of the DAP at the level of the image intensifier in most modern fluoroscopy units should allow an estima- tion of the skin doses delivered to the patients, provided that an appropriate methodology is developed to relate the parameter DAP to the actual skin dose under given physical and anatomical conditions.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, doses delivered to skin of the chest and shoulders may be of sufficient magnitude to cause clinically apparent injuries, ranging from mild erythema to severe cutaneous ulceration (Table I) [1][2][3][4][5]. The current generation of X-ray units used in interventional radiology benefit from improved imaging systems (digital image processing), diminished X-ray dose exposure, and on-line recording and monitoring of dose parameters (in cGy cm 2 ).…”

Section: Introductionmentioning

confidence: 99%

X-ray dose to the skin in patients undergoing percutaneous transluminal coronary angioplasty

Miralbell

Doriot

Nouet

et al. 2000

Cathet. Cardiovasc. Intervent.

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Dose measurements were performed with an ionization chamber placed on the surface of a polystyrene phantom to estimate the radiation dose to the skin from fluoroscopy in patients undergoing PTCA and to define parameters predicting for high-risk irradiation conditions. Dose rate changes were analyzed as a function of phantom thickness, X-ray source-to-phantom distance, image intensifier-to-phantom distance, and field size. Skin dose calculations were made in 38 PTCA patients to validate the model. Thickness was the most important factor determining dose rate changes in the phantom's surface. Dose rate increased by a factor of almost 4 with each 10-cm increment in thickness, doubled upon decreasing the field diameter from 17 cm to 14 cm, and increased by a factor of 1.2 to 1.8 upon decreasing the source-to-phantom distance or by increasing the image intensifier-to-patient distance. All these parameters may significantly increase the dose to the skin and augment the risk for skin injuries post-PTCA.

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Chronic Radiodermatitis Following Cardiac Catheterization

Cited by 104 publications

References 12 publications

Radiation exposure of patients and coronary arteries in the stent era: A prospective study

Radiation exposure of patients and coronary arteries in the stent era: A prospective study

Radiation Exposure of Medical Staff in Interventional Radiology

X-ray dose to the skin in patients undergoing percutaneous transluminal coronary angioplasty

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