Safety and efficacy of an ultra low dose fluoroscopic protocol for chronic total occlusion recanalization

Background Chronic total occlusion (CTO) revascularization is a major source of radiation for both patients and physicians. Therefore, efforts to minimize radiation during CTO percutaneous coronary intervention (PCI) are highly encouraged. Aims To evaluate the impact of an Ultra Low fluoroscopic Dos...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2023-04, Vol.101 (5), p.911-917
Main Authors: Bacci, Elodi, Chiarito, Mauro, Sanz‐Sanchez, Jorge, Leone, Pier Pasquale, Gohar, Aisha, Novelli, Laura, Kovacic, Mihajlo, Regazzoli, Damiano, Reimers, Bernhard, Contorni, Francesco, Ghionzoli, Nicolò, Cameli, Matteo, Gasparini, Gabriele L.
Format: Article
Language:English
Subjects:
Chronic Disease
chronic total occlusion
Coronary Angiography - adverse effects
Coronary Angiography - methods
coronary artery disease
Coronary Occlusion - diagnostic imaging
Coronary Occlusion - etiology
Coronary Occlusion - therapy
Fluoroscopy
Humans
Lesions
Occlusion
Patients
percutaneous coronary intervention
Percutaneous Coronary Intervention - adverse effects
Percutaneous Coronary Intervention - methods
Radiation
radiation exposure
Registries
Retrospective Studies
Risk Factors
Treatment Outcome
X‐ray
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Summary:Background Chronic total occlusion (CTO) revascularization is a major source of radiation for both patients and physicians. Therefore, efforts to minimize radiation during CTO percutaneous coronary intervention (PCI) are highly encouraged. Aims To evaluate the impact of an Ultra Low fluoroscopic Dose Protocol (ULDP), based on 3.75 frames per second for the fluoroscopy and 7.5 frames per second for the cine acquisition, during CTO PCI. Methods One hundred fifty consecutive patients who underwent CTO PCI were retrospectively enrolled. Eighty‐five underwent standard dose protocol (SDP) and 65 ULDP. Radiation exposure and acute clinical outcomes were compared between groups. Results were stratified according to lesion complexity. Results Patients undergoing ULDP, as compared to those undergoing SDP, showed a significant reduction of kerma area product, both for simple lesions (6861.0 vs. 13236.0 mGy × cm2; p = 0.014) and complex lesions (CL) (8865.0 vs. 16618.0 mGy × cm2; p 
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30605