Höhe und Röhrenangulation als die Determinanten der möglichen Untersucher-Ortsdosisleistung in der invasiven Kardiologie

Kuon, Eberhard; Empen, Klaus; Reuter, G; Dahm, Johannes B.

doi:10.1055/s-2004-813010

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…As shown in Figure 1 , the results showed that the operator receives the highest mean radiation dose in LAO cranial projection irrespective of the approach. This is in agreement with the reports by Kuon et al ( 9 ) and Pitney et al ( 21 ).…”

Section: Discussionsupporting

confidence: 94%

“…In addition, simultaneous measurement of the operator and patient radiation doses in different projections is of utmost importance in choosing the optimal approach. There are limited studies about the operator exposure during diagnostic coronary angiography ( 24 , 25 ), and most of our information comes from studies that have used phantom models ( 6 , 9 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, the majority of data has been obtained using phantom models ( 6 , 9 , 10 ) or old generation of angiography systems ( 7 ). The introduction of new angiography systems, which are equipped with improved image processing system, as well as the increase in operator experience call for review of the protocol of the coronary angiography procedures, particularly for some projections that are associated with high radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

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Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography

Tarighatnia¹,

Mohammadalian²,

Ghojazade³

et al. 2017

Anatol J Cardiol

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Objective:We aimed to compare the operator and patient radiation exposure in standard projections during elective diagnostic coronary angiography procedures via transradial (TRA) versus transfemoral (TFA) approaches.Methods:In this analytical cross-sectional study, a total of 202 consecutive patients who were candidates for diagnostic coronary angiography were randomized to undergo the procedure via TFA or TRA approaches (101 in each group). Patients with abnormal Allen test and history of coronary artery bypass surgery, valvular heart disease, and unsuccessful coronary angiography were excluded from the study. A single operator performed all of the procedures using a single angiography system. Patient and operator radiation exposure were measured using diamentor and an electronic personal dosimeter, respectively. Each procedure comprised a standardized sequence of projections including four standard views for the left coronary system and two standard views for the right coronary system.Results:Left anterior oblique (LAO) caudal (50°/30°) and right anterior oblique RAO (30°) projections were associated with the highest and lowest patient radiation exposure, respectively. The operator received a significantly higher radiation exposure in the TRA approach for LAO cranial (for both left and right coronary systems) and LAO caudal (for left coronary system) projections during coronary angiography compared with the TFA approach.Conclusion:Though a similar amount of patient radiation exposure in each projection was observed among TFA and TRA groups; LAO cranial and LAO caudal projections were associated with a significantly higher operator radiation exposure in the TRA group. These findings need to be considered when choosing the optimal arterial approach for patients scheduled for coronary angiography.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography

Tarighatnia¹,

Mohammadalian²,

Ghojazade³

et al. 2017

Anatol J Cardiol

View full text Add to dashboard Cite

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“…It should be acknowledged that there is a wide range of scatter radiation at the level of the doctors' eyes due to the variability of tube position 34 and routine angles may differ between institutions or due to doctor preference. Procedures routinely utilizing steeper left anterior obliques (LAO) or LAO cranial tube angles provided in Table 3 may increase the risk of occupational exposure 17,20 . Additionally, these measurements were taken at a single point, and due to the changing nature of the X-ray scatter profile may not reflect dose levels to other areas of the head.…”

Section: Discussionmentioning

confidence: 99%

Taller staff occupationally exposed to less radiation to the temple in cardiac procedures, but risk higher doses during vascular cases

Wilson‐Stewart

Fontanarosa

et al. 2020

Sci Rep

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This study aimed to evaluate the effect of nurse and doctor height on occupational dose to the temple during fluoroscopically guided cardiovascular procedures. Additionally, an evaluation of the relationship between doctor height and table height was performed. Staff exposed during fluoroscopic procedures may be at elevated risk of cardiovascular damage or oncogenesis and have demonstrated a higher incidence of subscapular cataracts. The heads of taller staff may be exposed to reduced levels of radiation due to the increased distance from the area of highest intensity X-ray scatter. Limited research has been performed investigating height as a predictor of head dose to nursing staff. The level of radiation dose at the level of the temple to the doctor (n = 25), scrub (n = 28), and scout nurse (n = 29) was measured in a prospective single-center, observational study using Philips DoseAware badges. Procedural characteristics were recorded for vascular and cardiac cases performed in three dedicated angiography suites. Data were also collected to investigate relationships between doctor height and table height. Data were collected for 1585 cardiac and 294 vascular procedures. Staff height was a statistically significant predictor of temple dose for doctors, scrub, and scout nurses when considering the full data sample. The log temple dose demonstrated an inverse relationship to staff height during cardiac procedures, but a positive relationship for scrub and scout nurses during vascular studies. This observational study has demonstrated that taller staff are exposed to less cranial exposure dose during fluoroscopically guided cardiac examinations but has revealed a positive correlation between height and temple dose during vascular procedures. It was also determined that doctor height was correlated with average procedural table height and that vascular access point influences the choice of table elevation.

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X‐ray exposure in cryoballoon versus radiofrequency ablation for atrial fibrillation over 7 years: A single center study

Heinroth

Blum

Drexler

et al. 2022

Journal of Arrhythmia

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Background Facing an increasing number of radiofrequency ablation (RF) and cryoballoon ablation (CB) procedures for treatment of AF radiation exposure and its reduction is a focus point for interventional electrophysiologists. Objective This study evaluated the procedural parameters of the different ablation methods focusing on radiation exposure and the BMI of the patients. Methods One thousand one hundred and thirty‐three first procedural cases of pulmonary vein isolation in patients with paroxysmal and persistent AF treated with RF and CB‐based techniques were analyzed retrospectively over a period of 7 years focusing on the endpoints dose area product (DAP, cGycm2), fluoroscopy time (FT, min) and procedural time (PT, min). Results Of the 1133 patients (mean age 63.4 ± 11.4 years, BMI 28.9 ± 4.7) 335 patients received an RF procedure, 211 patients were treated with the cryoballoon first generation (CB1), and 587 patients with cryoballoon second generation (CB2), respectively. The mean DAP for the PVI was 508 ± 654 cGycm2 in RF procedures, 1077 ± 683 cGycm2 in CB1‐procedures, and 587 ± 489 cGycm2 in CB2‐procedures with fluoroscopy times significantly shorter in RF procedures (9.6 ± 5.2 min) as compared to 17.7 ± 5.9 min in CB1‐ and 16.3 ± 6.3 min in CB2‐procedures (p < .001). At the same time, the procedure duration using RF (115 ± 33.5 min) was significantly longer than both in CB1 (96 ± 16.8 min) and CB2 procedures (75 ± 15.9 min). Conclusions Despite longer fluoroscopy durations in the CB technique, the CB2 resulted in a comparable low radiation exposure in PVI as compared to RF, accompanied by shorter procedure durations.

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Höhe und Röhrenangulation als die Determinanten der möglichen Untersucher-Ortsdosisleistung in der invasiven Kardiologie

Cited by 5 publications

References 14 publications

Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography

Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography

Taller staff occupationally exposed to less radiation to the temple in cardiac procedures, but risk higher doses during vascular cases

X‐ray exposure in cryoballoon versus radiofrequency ablation for atrial fibrillation over 7 years: A single center study

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