Procedural determinants of fluoroscopy time in patients undergoing cardiac catheterization

Abstract

Background & Objective: Due to increase in number of cardiac catheterization procedures safety concerns is an issue nowadays. Multiple diagnostic modalities use radiations, which also put a patient at higher cumulative radiation exposure. Therefore steps should be taken to minimize radiation exposure during cardiac catheterization. Hence determination of factors which prolong FT will result in better understanding of problem.This retrospective study was undertaken to determine factors responsible for prolong fluoroscopy time in patients undergoing coronary artery catheterization.
 Methods: This retrospective study was conducted at catheterization Laboratory National Institute of Cardiovascular Diseases, Karachi from June 2014 to June 2015. Patients of either gender, aged between 18 to 90 years undergoing cardiac catheterization procedures were included. Radiation exposure time was measured in terms of fluoroscopy time.
 Results: A total of 957 patients were included in this study out of which 731 were of diagnostic Coronary Angiograms (CA) and 226 were of Percutaneous Coronary Intervention (PCI). The mean age of the study participants was 54.12±10.89 years and majority 734(76.6%) were male. Mean fluoroscopy time (FT) in the patients subjected to PCI was 9.61±6.07 minutes while in cases for CA 4.17±4.13 minutes. FT for CA was observed significantly dependent on procedural access, operator’s experience, and LV angiogram. While FT for PCI was found dependent on number of stents deployed during the procedure.
 Conclusion: For invasive coronary angiographic procedures radial route increased fluoroscopy time. For percutaneous coronary intervention femoral and radial route fluoroscopy time were not significantly different.
 How to cite this:Mujtaba SF, Saghir T, Sial JA, Rizvi NH. Procedural determinants of fluoroscopy time in patients undergoing cardiac catheterization. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.294
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Evaluation of Procedure Doses and Staff Attitudes in Interventional Cardiology in Terms of Radiation Safety

“…A positive correlation between CAK and FT in cath lab cases 22,35,38 was also detected in this study, consistent with previous literature findings that radial and femoral approaches to coronary diagnostic angiograms did not differ in FTs. 41 PCI radiation doses and FT in university hospitals were found to be higher than in public hospitals. This disparity is attributed to the resident training process in university hospitals.…”

Association of the long fluoroscopy time with factors in contemporary primary percutaneous coronary interventions

“…In the multivariate stepwise logistic regression analysis, serum creatinine, cardiac arrest at prehospital or ER, three vessel disease, diffuse long lesion, moderate to excessive tortuosity, moderate to severe calcification, and big size of guiding catheter were associated with the long fluoroscopy-time, suggesting that complex lesion characteristics required longer fluoroscopy-time in primary PCI. Although there were several studies to find determinants of the long fluoroscopy time in PCI [14,15], there were few studies to find that in primary PCI for STEMI. In the present study, lesion length was significantly associated with the long fluoroscopy time.…”

“…Although there were several studies to find determinants of the long fluoroscopy time in PCI [ 14 , 15 ], there were few studies to find that in primary PCI for STEMI. In the present study, lesion length was significantly associated with the long fluoroscopy time.…”