Patient effective doses and radiation risks in cardiac catheterization procedures

Abstract

Cardiac catheterizations (CC) represent a set of interventional procedure used in the diagnosis and treatment of coronary arteries diseases. Whereas interventional procedures perhaps represent only some 12% of all radiological procedures they nevertheless contribute about 48% of the total collective dose worldwide. In a Sudanese based study, the objectives of present work have been to evaluate patient radiation dose and to estimate effective doses and cancer risks for three types of cardiac catheterization procedure. Radiation doses and the associated radiation risks have been evaluated for a total of 346 patients undergoing treatments for a range of clinical indications, including 187 Diagnostic Coronary Angiographic (DCA) procedures (54%), 118 Percutaneous Coronary Interventions (PCI) (34.1%) and 41 Pacemaker (PM) procedures (11.9%)). The respective effective dose ranges were 4.0- to 59.3 mSv, 11.4- to 175 mSv and 7.2- to 51.5 mSv. None of the present patient cohort developed tissue reactions, deterministic effects clearly being anathema in diagnostic radiological practice. With optimization of patient doses being fundamental to best practice, and with it an associated mitigation of stochastic risk, not least in regard to patients of younger age facing the greatest risk, there is particular concern regarding training and experience of radiographic staff, as results show.