Radiation doses to patients in coronary interventions in a hospital in Thailand

Abstract

Background: Radiation dose is best estimated by the Dose Area Product (DAP), the absorbed dose to air, multiplied by the X-ray beam cross-sectional area at the point of measurement. Interventional cardiologists should be made aware of the exposures to patients and how they compare to established norms. Objective: We assessed patient doses during coronary diagnostic and interventions then compared doses between two angiocardiographic systems in our center and through these actions. Methods and Results: In total, 308 (44.4%) diagnostic CAs, 229 (33.0%) one-vessel PCIs, 53 (7.6%) two or threevessel PCIs, and 15 (2.2%) PCIs to CTO were carried out. The mean DAP value for diagnostic CAs in room No. 1 (Siemens Axiom Artis dBC) was 45.2±28.7 Gy.cm 2, compared with room No. 2 (Philips Allura Xper biplane FD 20/10) where mean DAP value was 78.6±58.4 Gy.cm2 ( p < 0.001). The mean DAP value for one-vessel PCIs in room No. 1 was 97.8±67.5 Gy.cm2, compared with room No. 2, mean DAP value of 159.4±82.4 Gy.cm2 (p = 0.030). The mean DAP value for two or three-vessel PCIs in room No. 1 was 153.1±65.6 Gy.cm2, compared with room No. 2, mean DAP value of 168.0±94.7 Gy.cm2 (p = 0.070). DAP values per procedure in diagnostic CAs, one-vessel PCIs, and two or three-vessel PCIs in room No. 2 were higher than in room No. 1 after multivariable correction for weight and fluoroscopy time. Conclusions: Regular measurement of patient doses is an essential step to optimize exposure. It makes operators aware their own performance and allows comparisons with generally accepted practice.