Abstract

The aim was to analyze the effect of fractional flow reserve (FFR), intravascular ultrasound (IVUS) and optical coherence tomography (OCT) on fluoroscopy time (FT), radiation dose (RD) and contrast volume (CV) in patients undergoing coronary angiography. This case-control study included consecutive patients above the age of 18, who underwent coronary angiography. FT, RD, and CV after each procedure were retrospectively recorded. Multivariate models were used to demonstrate the effect of these complementary studies and other factors, on radiation and contrast exposure. A total of 1047 patients were included, 74.5% were men and the mean (SD) age was 62.4 (12.1) years. Complementary studies performed were: IVUS (n = 237), FFR (n = 56) and OCT (n = 37). FFR and IVUS had a small effect on FT (η = 0.008 B = 2.2, p < 0.001; η = 0.009, B = 2.5, p < 0.001), while OCT had no effect (η = 0.002 B = 2.9, p < 0.183). IVUS, FFR and OCT had no effect on the RD. IVUS did not affect contrast volume (η = 0.002 B = 9.4, p < 0.163) while OCT and FFR had a small effect on CV (η = 0.006 B = 39, p < 0.01; η = 0.008 B = 37, p < 0.003). The number of placed stents had a significant effect on FT (η = 0.192, Β = 4.2, p < 0.001), RD (η = 0.129, Β = 511.8, p < 0.001) and CV (η = 0.177, Β = 40.5, p < 0.001). The use of complementary studies in hemodynamics did not modify the received RD and had a minor effect on FT and the CV used.

Highlights

  • The aim of this study was to analyze the effect of angiographic complementary studies such as Fractional Flow Reserve (FFR), Intravascular Ultrasonography (IVUS) and Optical Coherence Tomography (OCT) on fluoroscopy time (FT), radiation dose (RD)* and contrast volume (CV) in patients undergoing coronary

  • Eighty one percent (81%) of the population was overweight with a mean (SD) body mass index (BMI) of 28 kg/m2 (4.2); 75.4% of patients (n = 809) had at least one comorbidity

  • FFR and IVUS had a small effect on FT (η = 0.008 p < 0.001; η = 0.009, B = 2.5, p < 0.001), while OCT had no effect (η = 0.002 B = 2.9, p < 0.183)

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Summary

Introduction

The aim of this study was to analyze the effect of angiographic complementary studies such as FFR, IVUS and OCT on fluoroscopy time (FT), radiation dose (RD)* and contrast volume (CV) in patients undergoing coronary. Other factors such as gender, body mass index (BMI), comorbidities, coronary lesion severity, the number of placed stents, and the number of complementary studies performed were addressed. Footnote: *RD is a measure of air kerma (equivalent to dose to air) at the measurement reference point, defined as a position 15 cm from the isocenter (x-ray tube side) along the central axis of the C-arm

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