Abstract
Background Percutaneous coronary intervention exposes patient and staff to ionizing radiation. Although staff only receive a small fraction of patient dose through scatter radiation, there are concerns about the potential health effects of repeated exposure. Minimizing both patient and occupational exposure is needed. Objective This article investigates patient and operator X-ray exposure over time in coronary intervention in relation to upgraded X-ray equipment, improved shielding, and enhanced operator awareness. Materials and Methods Data regarding irradiation time, patient dose, and patient characteristics were extracted from the Norwegian Registry for Invasive Cardiology (NORIC) for procedures performed from 2013 to mid-2019. Personal operator dosimetry records were provided by the Norwegian Radiation and Nuclear Safety Authority. Improved operator shielding and awareness measures were introduced in 2018. Results In the period 2013 through June 2019, 21499 procedures were recorded in our institution. Mean dose area product (DAP) for coronary angiography decreased 37% from 2981 μGy·m2 in 2013 to 1891 μGy·m2 in 2019 (p < 0.001). For coronary intervention, DAP decreased 39% from 8358 μGy·m2 to 5055 μGy·m2. Personal dosimetry data indicate a 70% reduction in operator dose per procedure in 2019 compared to 2013. The most pronounced reduction occurred after improved radiation protection measures were implemented in 2018 (−48%). Conclusions This study shows a temporal trend towards considerable reduction in X-ray doses received by the patient and operator during cardiac catheterization. Upgraded X-ray equipment, improved shielding, and enhanced operator awareness are likely contributors to this development.
Highlights
Each year, approximately 450,000 percutaneous coronary intervention procedures are performed in the United States [1]
The effect of low-dose radiation is still debated [3, 4], there are growing concerns among interventional cardiologists about the potential harmful health impact of long-term exposure to scatter radiation [5,6,7,8,9]. e International Commission on Radiation Protection recommends that X-ray exposure should be kept as low as reasonably achievable with recommended dose limits of
We aimed to investigate patient and operator X-ray exposure over time in coronary intervention in relation to upgraded X-ray equipment, improved shielding, and enhanced operator awareness
Summary
Approximately 450,000 percutaneous coronary intervention procedures are performed in the United States [1]. During these procedures, the acquisition of X-ray images exposes patient and staff to ionizing radiation. Staff only receive a small fraction of patient dose through scatter radiation, there are concerns about the potential health effects of repeated exposure. Minimizing both patient and occupational exposure is needed. Is article investigates patient and operator X-ray exposure over time in coronary intervention in relation to upgraded X-ray equipment, improved shielding, and enhanced operator awareness. Upgraded X-ray equipment, improved shielding, and enhanced operator awareness are likely contributors to this development
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