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Circ Cardiovasc Interv. 2017 Aug;10(8). pii: e005268. doi: 10.1161/CIRCINTERVENTIONS.117.005268.

Time-Course Reduction in Patient Exposure to Radiation From Coronary Interventional Procedures: The Greater Paris Area Percutaneous Coronary Intervention Registry.

Author information

1
From the Cardiology Department (J.-L.G., B.L.), Emergency Department (S.B.), and SAMU 78 (Y.L.), Versailles Hospital (André Mignot), Le Chesnay, France; Paris Cardiovascular Research Center, INSERM Unit 970, France (N.K., M.T., C.S., X.J.); Cardiology Department, European Georges Pompidou University Hospital (N.K., C.S., X.J.), Cardiology Department, University Hospital Cochin (O.V.), and Cardiology Department, University Hospital Henri Mondor (E.T.), Assistance Publique-Hôpitaux de Paris, France; Université Paris-Descartes, France (N.K., M.T., C.S., X.J.); Agence Régionale de Santé d'Ile-de-France (ARSIF), Paris (S.B., A.L., M.M.); Cardiology Department, Foch Hospital, Suresnes, France (H.B.); Cardiology Department, ICPS, Massy, France (H.B.); Cardiology Department, Institut Mutualiste Montsouris, Paris, France (C.C.); Cardiology Department, ICPS, Quincy sous Sénart, France (P.G.); Cardiology Department, Hôpital d'Instruction des Armées Percy, Clamart, France (F.B.); Cardiology Department, René Dubos Hospital, Pontoise, France (F.F.); and Cardiology Department, Simone Veil Hospital, Eaubonne, France (G.K.). jgeorges@ch-versailles.fr.
2
From the Cardiology Department (J.-L.G., B.L.), Emergency Department (S.B.), and SAMU 78 (Y.L.), Versailles Hospital (André Mignot), Le Chesnay, France; Paris Cardiovascular Research Center, INSERM Unit 970, France (N.K., M.T., C.S., X.J.); Cardiology Department, European Georges Pompidou University Hospital (N.K., C.S., X.J.), Cardiology Department, University Hospital Cochin (O.V.), and Cardiology Department, University Hospital Henri Mondor (E.T.), Assistance Publique-Hôpitaux de Paris, France; Université Paris-Descartes, France (N.K., M.T., C.S., X.J.); Agence Régionale de Santé d'Ile-de-France (ARSIF), Paris (S.B., A.L., M.M.); Cardiology Department, Foch Hospital, Suresnes, France (H.B.); Cardiology Department, ICPS, Massy, France (H.B.); Cardiology Department, Institut Mutualiste Montsouris, Paris, France (C.C.); Cardiology Department, ICPS, Quincy sous Sénart, France (P.G.); Cardiology Department, Hôpital d'Instruction des Armées Percy, Clamart, France (F.B.); Cardiology Department, René Dubos Hospital, Pontoise, France (F.F.); and Cardiology Department, Simone Veil Hospital, Eaubonne, France (G.K.).

Abstract

BACKGROUND:

The frequency of complex percutaneous coronary interventions (PCIs) has increased in the last few years, with a growing concern on the radiation dose received by the patients. Multicenter data from large unselected populations on patients' radiation doses during coronary angiography (CA) and PCI and temporal trends are lacking. This study sought to evaluate the temporal trends in patients' exposure to radiation from CA and PCI.

METHODS AND RESULTS:

Data were taken from the CARDIO-ARSIF registry that prospectively collects data on all CAs and PCIs performed in the 36 catheterization laboratories in the Greater Paris Area, the most populated regions in France with about 12 million inhabitants. Kerma area product and Fluoroscopy time from 152 684 consecutive CAs and 103 177 PCIs performed between 2009 and 2013 were analyzed. A continuous trend for a decrease in median [interquartile range] Kerma area product was observed, from 33 [19-55] Gy cm2 in 2009 to 27 [16-44] Gy cm2 in 2013 for CA (P<0.0001), and from 73 [41-125] to 55 [31-91] Gy cm2 for PCI (P<0.0001). Time-course differences in Kerma area product remained highly significant after adjustment on Fluoroscopy time, PCI procedure complexity, change of x-ray equipment, and other patient- and procedure-related covariates.

CONCLUSIONS:

In a large patient population, a steady temporal decrease in patient radiation exposure during CA and PCI was noted between 2009 and 2013. Kerma area product reduction was consistent in all types of procedure and was independent of patient-related factors and PCI procedure complexity.

KEYWORDS:

Kerma area product; catheterization; coronary angiography; fluoroscopy; percutaneous coronary intervention; radiation protection

[Indexed for MEDLINE]

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