Patient exposure data and operator dose in coronary interventional procedures: Impact of body-mass index and procedure complexity.

Zanca, Federica;Collard, Céline;Alexandre, Nicolas;Deprez, Frédéric;Massart, Pierre Emmanuel;et.al.
(2020) Physica Medica : an international journal devoted to the applications of physics to medicine and biology — Vol. 76, p. 38-43 (2020)

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Authors
  • Zanca, Federica
    Author
  • Collard, CélineUCLouvain
    Author
  • Alexandre, Nicolas
    Author
  • Deprez, FrédéricUCLouvain
    Author
  • Salembier, Jean-PaulUCLouvain
    Author
  • Rombaut, EmmanuelUCLouvain
    Author
  • Massart, Pierre Emmanuel
    Author
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Abstract
(en) PURPOSE: The aim of this study was to assess patient exposure data and operator dose in coronary interventional procedures, when considering patient body-mass index and procedure complexity. METHODS: Total air kerma area product (PKA), Air-Kerma (AK), Fluoroscopy time (FT), operator dose and patient body-mass index (BMI) from 97 patients' procedures (62 coronary angiography (CA) and 35 Percutaneous Coronary Intervention (PCI) were collected for one year. For PCI procedures, also the complexity index-CI was collected. Continuous variables for each of the 2 groups procedures (CA and PCI) were compared as medians with interquartile range and using Mann-Whitney U test. Multiple group data were compared using Kruskal-Wallis test (significance: p < 0.05). RESULTS: Median PKA was 63 and 125 Gy cm2 for CA and PCI respectively (p < 0.001); FT was 3 and 14 min, respectively (p < 0.001). PKA and FT significantly increased (p < 0.05) with BMI class for CA procedures. PKA and FT also increased in function of CI class for PCI, thought significantly only for FT (p < 0.001), possibly because of the low number of PCI procedures included; cine mode contributed most to PKA. Significant dose variability was observed among cardiologists for CA procedures (p < 0.001). CONCLUSIONS: Dose references levels for PKA and FT in interventional cardiology should be defined - on a sufficient number of procedures- in function of CI and BMI classes. These could provide an additional tool for refining a facility's quality assurance and optimization processes. Dose variability associated with cardiologists underlines the importance of continuous training.
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Zanca, F., Collard, C., Alexandre, N., Deprez, F., Salembier, J.-P., Henry, M., Rombaut, E., & Massart, P. E. (2020). Patient exposure data and operator dose in coronary interventional procedures: Impact of body-mass index and procedure complexity. Physica Medica : an international journal devoted to the applications of physics to medicine and biology, 76, 38-43. https://doi.org/10.1016/j.ejmp.2020.05.006 (Original work published 2020)