Background We performed a detailed analysis of patient radiation during
coronary interventions, comparing dose measurements to established dose
reference levels, assessing coronary artery doses, and estimating total
radiation risk of fatal cancer.
Methods We prospectively examined 281 patients who were subjected to 307
percutaneous coronary interventions.
Results The mean kerma area product (KAP) per procedure was 82.1 +/-
47.9 Gy. cm(2). Corresponding values for fluoroscopy and digital
cineangiography were 28.3 +/- 25.5 Gy cm(2) and 53.8 +/- 35.5 Gy. cm(2),
respectively, and exposure times were 13.1 +/- 6.8 minutes (87%) and
2.0 +/- 1.5 minutes (13%), respectively. The right anterior oblique
caudal and left anterior oblique cranial projections accounted for the
highest amount of KAP (24.0% and 23.1%, respectively) compared with
other projections. The maximum recorded skin-dose was 182 mGy.
Performing a representative procedure on a phantom, the effective dose
was 14.9 mSv. The mean coronary dose was 61.7 +/- 38.2 mGy, with a
highest calculated dose of 220.1 mGy. The third quartile of KAP
measurements was 105 Gy. cm(2), the 95th percentile was 175 Gy. cm(2),
and the mean value of KAP measurements was 82 Gy.cm(2). The total risk
for the development of fatal cancer was calculated as 83 cases for every
100,000 patients subjected to coronary intervention.
Conclusions A detailed analysis of patient radiation during coronary
interventions is presented. Coronary doses and total radiation risk of
fatal cancer are also calculated, and a method for establishing dose
reference level values is proposed
