Factors contributing to radiation dose for patients and operators during diagnostic cardiac angiography

Abstract

Introduction Diagnostic coronary angiography (CA) uses ionising radiation with relatively high doses, which impact on both patients and staff. This study sought to identify which patient and procedural factors impact patient and operator dose the most during CA. Methods Patient and procedure related variables impacting on Kerma area product (PKA) and operator dose (OD) were collected for 16 months. Procedures were separated into 10 different procedure categories. PKA was used for patient dose and OD was measured with an instantly downloadable dosimeter (IDD) – downloaded at the end of each procedure. High and low radiation dose was defined by binary variables based on the 75th percentile of the continuous measures. Univariate and multivariate regression were used to identify predictors. Results Of 3860 patients included, the IDD was worn for 2591 (61.7%). Obesity (BMI > 30 compared to BMI < 25) was the strongest predictor for both a PKA (odds ratio (OR) = 19.1 (95% CI 13.5–26.9) P < 0.001) and OD (OR = 3.3 (2.4–4.4) P < 0.001) above the 75th percentile. Male gender, biplane imaging, the X‐ray unit used, operator experience and procedure type also predicted a high PKA. Radial access, male gender, biplane imaging and procedure type also predicted a high OD. Conclusion Radiation dose during CA is multifactorial and is dependent on patient and procedure related variables. Many factors impact on both PKA and OD but obesity is the strongest predictor for both patients and operators to receive a high radiation dose.

Comparison of radiation dose and its correlates between coronary computed tomography angiography and invasive coronary angiography in Northeastern Thailand

“…For CCTA, the effective radiation dose was correlated with higher weight, BMI, and height, demonstrated by another study [ 16 ]. For ICA, the effective radiation dose correlated with higher BMI and weight, in line with published data [ 17 ].…”

Full feature selection for estimating KAP radiation dose in coronary angiographies and percutaneous coronary interventions

“…Compared to the recent results on factors contributing to high radiation dose in CA published by Crowhurst et al (2019), the assessed features were different but similarities in the results can nonetheless be found. The most important statistically significant factors reported by Crowhurst et al were patient weight, PCI and gender.…”

“…However, the set of features that should be combined into such estimate remains an open question. In 2001 Padovani et al (2001) and in 2005Peterzol et al (2005 published their pioneering works on the topic, but the only recent publication on features that predict high radiation dose is by Crowhurst et al (2019) who utilised a more conventional methodology.…”

Comparison of radiation exposure and clinical outcomes between transradial and transfemoral diagnostic cerebral approaches: a retrospective study

“…12 The parameters affecting the patient radiation dose exposure and the clinical consequences are the duration of the procedure, operator experience, catheters and devices used, independent patient and vascular characteristics (lesions or anatomic variants) as well as the type of vascular approach (TRA and TFA). 13 However, the studies comparing TRA versus TFA approaches have not been comprehensive and have mostly only evaluated the absorbed radiation dose as a secondary outcome variable. Also, data on quality of life (QOL)/patient satisfaction in previous studies 2 5 14 has been limited to postprocedure complication rate and recovery time.…”

“…Efforts to minimise radiation exposure are of paramount importance because of the potential for biological effects, including skin injuries and radiation-induced cancers 12. The parameters affecting the patient radiation dose exposure and the clinical consequences are the duration of the procedure, operator experience, catheters and devices used, independent patient and vascular characteristics (lesions or anatomic variants) as well as the type of vascular approach (TRA and TFA) 13. However, the studies comparing TRA versus TFA approaches have not been comprehensive and have mostly only evaluated the absorbed radiation dose as a secondary outcome variable.…”