Author + information
- Mohamed Teleb1,
- Aymen Albaghdadi1,
- Ahmed Ibrahim1,
- Debabrata Mukherjee2,
- Harsh Agrawal3,
- Juan Marmol-Velez1,
- Tariq Siddiqui3 and
- Subrata Kar3
- 1Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas, United States
- 2Texas Tech University Medical School, El Paso, Texas, United States
- 3Division of Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
Radiation exposure from various imaging modalities increases the risk for malignancy. Coronary angiography is a common source of radiation. The safety and feasibility of low dose versus standard dose radiation in adult cardiac catheterization and intervention has not been previously evaluated.
We performed a retrospective study of 393 consecutive patients (61±12 years), who underwent coronary angiography or percutaneous coronary intervention from September 2016 to June 2017. Patients were divided into a low dose radiation group (n=81) consisting of 1, 4, and 7.5 frames/second (f/s) fluoroscopy and 7.5 f/s cine angiography vs. standard dose (n=310) of 10, 15, and 30 f/s fluoroscopy and 10, 15, or 30 f/s cine angiography. Primary endpoints included dose area product, air kerma (skin dose), fluoroscopy time, and contrast use.
In the low dose radiation group vs. the standard dose, there was a statistically significant reduction in dose area product (3,999.35 ± 5,125.35 mGy·cm2 vs. 8,027.61 ± 9,461.12 mGy·cm2, p<0.005) and air kerma (525.51 ± 838.89 mGy vs. 1,111.05 ± 1,431.72 mGy, p= <0.005). However, no significant difference was noted in the fluoroscopy time (21.43 ± 17.72 minutes vs. 17.31 ± 14.20 minutes, p=0.054) or contrast use (148.06 ± 99.48 ml vs. 137.80 ± 83.60 ml, p=0.434).
Low dose radiation showed a significant radiation reduction without an increase in fluoroscopy time or contrast utilization. Thus, use in adult cardiac catheterization is technically feasible and safe for the patient and operator. Such radiation protocols can have a clinically meaningful impact for society and the future of cardiology.