Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Can J Cardiol. 2017 Apr;33(4):478-484. doi: 10.1016/j.cjca.2016.11.002. Epub 2016 Nov 11.

Predictors of Excess Patient Radiation Exposure During Chronic Total Occlusion Coronary Intervention: Insights From a Contemporary Multicentre Registry.

Author information

1
VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas, USA.
2
Columbia University, New York, New York, USA.
3
Henry Ford Hospital, Detroit, Michigan, USA.
4
Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
5
Torrance Memorial Medical Center, Torrance, California, USA.
6
University of Washington, Seattle, Washington, USA.
7
Mid America Heart Institute, Kansas City, Missouri, USA.
8
Piedmont Heart Institute, Atlanta, Georgia, USA.
9
Minneapolis VA Healthcare System and University of Minnesota, Minneapolis, Minnesota, USA.
10
Medical Center of the Rockies, Loveland, Colorado, USA.
11
Boston Scientific, Natick, Massachusetts, USA.
12
VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas, USA; Minneapolis Heart Institute, Minneapolis, Minnesota, USA. Electronic address: esbrilakis@gmail.com.

Abstract

BACKGROUND:

High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury.

METHODS:

We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015.

RESULTS:

The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG). Technical and procedural success was 92% and 90%, respectively. The median patient AK dose was 3.40 (interquartile range, 2.00-5.40) Gy and 34% of the patients received > 4.8 Gy (high radiation exposure). In univariable analysis male sex (P = 0.016), high body mass index (P < 0.001), history of hyperlipidemia (P = 0.023), previous CABG (P < 0.001), moderate or severe calcification (P < 0.001), tortuosity (P < 0.001), proximal cap ambiguity (P = 0.001), distal cap at a bifurcation (P = 0.006), longer CTO occlusion length (P < 0.001), blunt/no blunt stump (P < 0.001), and centre (P < 0.001) were associated with higher patient AK dose. In multivariable analysis high body mass index (P < 0.001), previous CABG (P = 0.005), moderate or severe calcification (P = 0.005), longer CTO occlusion length (P < 0.001), and centre (P < 0.001) were independently associated with higher patient AK dose.

CONCLUSIONS:

Approximately 1 in 3 patients who undergo CTO PCI receive high AK radiation dose (> 4.8 Gy). Several baseline clinical and angiographic characteristics can help predict the likelihood of high radiation dose and assist with intensifying efforts to reduce radiation exposure for the patient and the operator.

PMID:
28169091
PMCID:
PMC5367931
DOI:
10.1016/j.cjca.2016.11.002
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center