Is Dual-Axis Rotational Coronary Angiography Radiation Dose Reduction Achievable in a Population with 100% Suspected Coronary Artery Disease? A Randomized Trial

Szarfer, Jorge; Albornoz, Federico; Alonso, Analía; Yurko, Vielka; Blanco, Federico; Blanco, Rodrigo; Indavere, Agustín; Gigena, Gerardo; Gagliardi, Juan; Escudero, Alejandro García

doi:10.1016/j.jmir.2019.12.009

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…Adverse events were also similar between the two groups except for transient asymptomatic bradycardia. Although safety and usefulness of DARCA have been shown in scheduled PCI for chronic coronary artery disease and NSTEMI patients [11,13,14,[20][21][22][23], our study shows safety and usefulness in primary PCI, as well. We believe the significant reduction in contrast medium volume and radiation exposure in the DARCA is probably due to the fact that the number of angiographic runs for pre-PCI coronary angiography was small in DARCA cases.…”

Section: Discussionmentioning

confidence: 51%

“…If left main trunk occlusion lesions and right coronary artery proximal occlusion lesions can be confirmed in the first test shot, it is desirable to perform CCA. To target both avoiding increase in the number of angiographic runs and acquisition of highquality imaging, however, DARCA combined with CCA would be promising [14]. Actually, in the present study, 73% of the patients in DARCA group underwent DARCA combined with CCA.…”

Section: Discussionmentioning

confidence: 69%

“…Coronary artery rotation imaging has since evolved to the dualaxis rotational coronary angiography (DARCA) system. Numerous studies have demonstrated that DARCA reduces contrast medium volume and radiation exposure while ensuring diagnostic accuracy compared to CCA [9][10][11][12][13][14]. Most studies regarding DARCA, however, have focused on its use in scheduled coronary angiography and elective percutaneous coronary intervention (PCI) for patients with chronic coronary artery disease or non-ST-elevation myocardial infarction (NSTEMI).…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction

et al. 2020

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Several studies have shown that dual-axis rotational coronary angiography (DARCA) reduces contrast medium volume and radiation exposure compared to conventional coronary angiography (CCA). However, there are no studies comparing the safety and usefulness of DARCA in primary percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the effects of DARCA on contrast medium volume, radiation exposure, time course of treatment, and adverse events in primary PCI for patients with STEMI. A total of 82 patients undergoing primary PCI were included in this study. Subjects were propensity matched to 41 patients in the CCA group and 41 in the DARCA group. Data were retrospectively collected from in-patient medical records and the contrast medium volume and radiation exposure (dose-area product, DAP) during the PCI procedure was compared between the two groups. Contrast medium volume [100.0 (82.5–115.0) vs 110 (102.5–127.5) ml, p = 0.018, r = 0.26] and DAP [113.4 (74.3–141.1) vs 138.1 (100.5–194.7) Gy cm2, p = 0.014, r = 0.27] were significantly lower in the DARCA group, compared with the CCA group. Door to device time (68.7 ± 26.1 vs 76.5 ± 44.2 min, p = 0.33) were comparable between the two groups. There were no adverse events requiring treatment reported in either groups. DARCA may reduce contrast medium volume and radiation exposure in primary PCI for patients with STEMI, and can be used safely, without delaying reperfusion of the infarct-related coronary artery.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction

et al. 2020

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A systematic review of conversion factors between kerma-area product and effective/organ dose for cardiac interventional fluoroscopy procedures performed in adult and paediatric patients

et al. 2022

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The aim of this systematic review is to undertake a critical appraisal of the evidence in the published literature concerning the conversion factors between kerma-area product (PKA) and effective/organ dose (DCED_PKA, DCHT_PKA) for cardiac interventional fluoroscopy procedures performed in adults and paediatric patients and to propose reference conversion factors to help standardize dose calculations. A search strategy utilizing MeSH headings in three databases identified 59 (adult) and 37 (paediatric) papers deemed eligible for the review. Exclusion criteria were adopted to select data only from publications which established DCED_PKA in patients using the ICRP103 tissue weighting factors. A time restriction from January 2007 was introduced in the search to capture the evolving trends of utilization of fluoroscopy-guided intervention technologies only in recent years. The suggested DCED_PKA and DCHT_PKA were synthesized by calculating the weighted averages of the values reported by the authors with weights corresponding to the study sample size. Eighteen studies for both adult (9) and paediatric (9) patients matching the search terms fulfilled the inclusion criteria. The suggested value for DCED_PKA in adult patients amounts to 0.24 mSvGy-1cm-2. The suggested values for DCHT_PKA ranged from a minimum of 0.15 mSvGy-1cm-2 for the female breast to a maximum of 0.97 mSvGy-1cm-2 for the lungs. The suggested values for DCED_PKA in paediatric patients ranged from 3.45 mSvGy-1cm-2 for the new-born to 0.49 mSvGy-1cm-2 in the 15-years age class. The suggested values for DCHT_PKA ranged from a minimum of 0.33 mSvGy-1cm-2 for bone marrow in the 15-years age class to a maximum of 11.49 mSvGy-1cm-2 for the heart in the new-born. To conclude, values of DCED_PKA/DCHT_PKA were provided for calculating effective/organ doses in cardiac interventional procedures. They can be useful for standardizing dose calculations, hence for comparison of the radiation detriment from different imaging procedures and in the framework of epidemiologic studies.

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Is Dual-Axis Rotational Coronary Angiography Radiation Dose Reduction Achievable in a Population with 100% Suspected Coronary Artery Disease? A Randomized Trial

Cited by 2 publications

References 22 publications

Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction

Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction

A systematic review of conversion factors between kerma-area product and effective/organ dose for cardiac interventional fluoroscopy procedures performed in adult and paediatric patients

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