Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? - Analysis of 568 Patients

• Published in: Arquivos brasileiros de cardiologia 2015-11, Vol.105 (5), p.487-492
• Main Authors: Truffa, Márcio A M, Alves, Gustavo M P, Bernardi, Fernando, Esteves Filho, Antonio, Ribeiro, Expedito, Galon, Micheli Z, Spadaro, André, Kajita, Luiz J, Arrieta, Raul, Lemos, Pedro A
• Format: Article
• Language: English
• Subjects: Aged; Angiografia Coronária; Angioplastia Coronária com Balão; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiac Catheterization - methods; Cateterismo Cardíaco; Coronary Angiography; Drug-Eluting Stents; Female; Fluoroscopia; Fluoroscopy - methods; Humans; Male; Middle Aged; Monitoramento da Radiação; Percutaneous Coronary Intervention - methods; Prospective Studies; Radiation Dosage; Radiation Exposure - prevention & control; Radiation Monitoring; Risk Factors; Statistics, Nonparametric; Time Factors
• ISSN: 0066-782X; 1678-4170; 1678-4170
• DOI: 10.5935/abc.20150110

Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention. To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedureMethods:The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated. A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 ± 70.7 Gycm2, while the staged group, to 139.2 ± 75.3 Gycm2 (p < 0.001). Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times.