Dose‐reducing fluoroscopic system decreases patient but not occupational radiation exposure in chronic total occlusion intervention

• Published in: Catheterization and cardiovascular interventions 2021-11, Vol.98 (5), p.895-902
• Main Authors: Salinas, Pablo, Sanchez‐Casanueva, Roberto M., Gonzalo, Nieves, Gil, Jorge, Salazar, Carlos H, Jimenez‐Quevedo, Pilar, Nombela‐Franco, Luis, Nuñez‐Gil, Ivan, Mejia‐Renteria, Hernan, Fernandez‐Soto, Jose M., Fernandez‐Ortiz, Antonio, Vaño, Eliseo, Escaned, Javier
• Format: Article
• Language: English
• Subjects: Biometrics; chronic total occlusion; Demography; Dosimetry; equipment safety; in vivo dosimetry; Occlusion; Occupational exposure; percutaneous coronary intervention; Radiation; radiation exposure
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.29253

Aims Several novel low‐dose fluoroscopic systems (LDS) developed recently, but real practice information of the net benefit for the patient and professionals is scarce. We evaluated separately patient and operator radiation exposure during percutaneous interventions of chronic total occlusions (CTO). Methods A total of 116 consecutive CTOs were analyzed (60 in LDS and 56 in standard‐dose fluoroscopic system [SDS]). Digital dosimetry of patient and occupational (operator and scatter dose) exposure was prospectively recorded. Results Biometrics, demographics, CTO variables, and operators were distributed evenly. Patient radiation exposure was effectively decreased in LDS (dose area product [DAP] by 36%, Air Kerma [AK] by 47%). However, occupational data showed no statistical differences between LDS and SDS. The LDS uses less radiation amount but with higher energy (due to additional filtration) compared to SDS, therefore increasing the scatter dose. When comparing the C‐arm scatter dose to the DAP we found higher scatter dose with the LDS (0.0139 mSv/gray (Gy)*cm2 vs. 0.0082 mSv/Gy*cm2, p