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Low dose interventional X-ray Systems have shown to substantially reduce radiation dose in the pediatric and adult structural and interventional realm. We evaluated our single center experience with Phillips, AlluraClarity software for all cardiovascular procedures; we also compared performance relative to patient body size.
A total of 1,155 patients were included. Dose area product (DAP) for radiation exposure, along with body surface area (BSA) and fluoroscopy time was retrospectively collected for n=467 one year pre clarity, and n=688 post. DAP was then compared to BSA and fluoroscopy time. BSA was categorized into four quartiles to assess relationship between radiation dose across small to large patient size population.
Mean BSA between two groups was similar (2.03 vs 2.02 m2, p=0.48) with 44.7% reduction in radiation dose seen with DAP indexed to BSA. Significant reduction in radiation dose was seen across all quartiles with highest reduction in post clarity sample population with largest BSA (Figure 1). Although fluoroscopy time in pre clarity was lower than post, mean 7.6 vs 10.2 minutes (p=<0.001), there was still a total 57.7% radiation dose reduction with DAP indexed to fluoroscopy time (p=<0.001). Overall, there was a 45.2% decrease in radiation dose with AlluraClarity (p=<0.001).
AlluraClarity significantly reduced overall radiation dose and this reduction was irrespective of BSA. The largest reduction in radiation was seen in patients with highest BSA suggesting obese patient derive the most benefit. To our knowledge this is the first study to describe this relationship with BSA and alluraclarity. The clarity system also substantially reduced radiation dose despite longer fluoroscopy time.
CORONARY: Angiography and QCA