54 Development of a model for predicting radiological risks in interventional cardiology

Abstract

Introduction The aim of the study is to estimate, before intervention, the radiation dose that will be delivered to the patient during a recanalization of Chronic Total Occlusion (CTO). Relevant clinical indicators should be selected to predict, at best, the risk of deterministic effects and improve patient care. Methods 103 CTO procedures were performed in a department of interventional cardiology with a Siemens Artis Zee C-arm giving Air Kerma. The peak skin dose was measured for each intervention, using radiochromic films. Patient parameters, such as gender, age weight and height were recorded. The complexity index (J-CTO score) which is specific to each intervention, was determined by the cardiologist. A correlation study has clarified the impact of these indicators on the dose. A predictive model of the dose to the patient was found. Results Of the 103 patients studied, 5 were excluded from the study for clinical reasons, 2 others because radiochromic films were outside of the exposure field. Finally, 96 2D dose maps were used for the study. The factors showing the highest correlation with the peak skin dose are patient diameter and J-CTO score. The prediction model is therefore based on these two parameters. The comparison between the predicted skin dose and measured skin dose showed an average difference of 0.85 ± 0.55 Gy for doses less than 6 Gy. The average difference between Air-Kerma and peak skin dose is about 1.66 Gy ± 1.16 Gy. Conclusions An initial estimate of the skin dose to the patient is given prior to the start of the intervention. This indication helps the cardiologist to work effectively and safely. This predicted dose is more accurate than the estimate provided by the air-kerma.