Abstract
Introduction: We aimed to determine angiography projections with lower Dose Area Product (DAP) rate by measuring the mean DAP and fluoroscopy times in coronary angiography (CAG) and percutaneous coronary intervention (PCI) and calculating DAP rate in different projections. Methods: DAP and fluoroscopy times were measured in all employed projections in real-time in 75 patients who underwent CAG or PCI by a single cardiologist in Madani Cardiovascular University Hospital (45 in CAG group and 30 in PCI group). DAP rate was calculated in both groups and in all projections. The projections with highest and lowest DAP rate were determined. Results: Mean DAP was 436.73±315.85 dGy×cm2 in CAG group and 643.26±359.58 dGy×cm2 in PCI group. The projection 40° LAO/0° had the highest DAP rate in CAG group (28.98 dGy×cm2/ sec) and it was highest in 20° RAO/30° CR in PCI group (29.83 dGy×cm2/sec). The latter projection was also the most employed projection in PCI group. Conclusion: The amount of radiation dose in this study is in consistent with the previous reports. Specific angiographic projections expose patients to significantly higher radiation and they should be avoided and replaced by less irradiating projections whenever possible.
Highlights
We aimed to determine angiography projections with lower Dose Area Product (DAP) rate by measuring the mean DAP and fluoroscopy times in coronary angiography (CAG) and percutaneous coronary intervention (PCI) and calculating DAP rate in different projections
The range of projections were from 50° Right Anterior Oblique (RAO) to the 50° Left Anterior Oblique (LAO) and from 40° cranial (CR) to 40° caudal (CA)
The range of projections in PCI were from 50° RAO to 60° LAO and from 40° cranial to 40° caudal
Summary
We aimed to determine angiography projections with lower Dose Area Product (DAP) rate by measuring the mean DAP and fluoroscopy times in coronary angiography (CAG) and percutaneous coronary intervention (PCI) and calculating DAP rate in different projections. The projection 40° LAO/0° had the highest DAP rate in CAG group (28.98 dGy×cm2/ sec) and it was highest in 20° RAO/30° CR in PCI group (29.83 dGy×cm2/sec). Stochastic effects of radiation lead to a damage that may end in a malignancy, generally at a much later time.[8,9] In both CAG and PCI, patient radiation exposure can be influenced by some factors such as patient obesity, the complexity of the procedure, and tube angulations.[10]
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