Implementation of system for follow-up of patients undergoing high dose interventional procedures

Congress:

EuroSafe Imaging 2017

Poster Number:

ESI-0049

Type:

EuroSafe Imaging

Keywords:

Treatment effects, Stents, Balloon occlusion, Fluoroscopy, Radioprotection / Radiation dose, Management, Interventional vascular, Action 12 - Information for and communication with patients, Action 13 - Stakeholder engagement and collaboration, Action 8 - Radiation protection training and learning material, Action 11 - Improved patient communication, Action 10 - Improved communication and collaboration of health professionals in radiation protection, Action 6 - Education and training in medical radiation protection, Dosimetric comparison, Education and training, Quality assurance

Authors:

D. Kostova-Lefterova, H. Mateev, A. Aleksandrov, I. Bogov, K. Genova, N. I. Traykova, D. P. Ivanova, A. Zagorska

DOI:

10.1594/esi2017/ESI-0049

DOI-Link:

https://dx.doi.org/10.1594/esi2017/ESI-0049

Background/Introduction

Radiation-induced injuries to patient’s skin as a result of high dose fluoroscopy guided interventional procedures are infrequently reported, often misdiagnosedand there is need tofollow up of patient. The ICRP, the International Atomic Energy Agency (IAEA), a number of national organizations and major publications have issued guidelines for recording patient radiation dose in the medical record for fluoroscopically guided procedures, and for follow up of patient with a potential for tissue reaction.If diagnosed properly and timely, the injury could be limited and treated in the least...

Description of activity and work performed

As a step of the implementation of a system for follow-up of patients undergoing high dose interventional procedures, a survey was performed to study the frequency of occurrence of patients exceeding the proposed trigger levels. Every patient exceeding a defined dose was asked to contact the interventionalists in case of reddening or itching on the skin. Such a proactive mechanism in place to call or contact patient at about 1 week to 6 months after high exposure to rule out injury, could discover most of...

Conclusion and Recommendations

The first results from the implementation of the system for follow-up of patients didn't show any positive skin reactions for the patients in hospital A. In all other hospitals the system is still in process of implementation. Until the moment of the survey there were no patients reporting radiation-induced effects. The awareness of medical staff in the interventional cardiology departments in all four hospitals increased. A system has been established for recording, in the medical report, the following exposure values: fluoroscopy time, number of series...

Personal/Organisational information

The system is implemented by a multidisciplinary team of medical physicists, interventional cardiologists, radiologists, radiographers and nurses. In all four hospitals are situated ones the biggest interventional cardiology departments in the country and all of them are places for education of residents.

References

Little MP. Risks associated with ionizing radiation. Br Med Bull 2003; 68: 259 – 275. Hall EJ. Radiation biology for paediatric radiologists. PediatrRadiol 2009; 39 (suppl 1):S57 – S64. National Research Council. Health risksfrom exposure to low levels of ionizing radiation:BEIR-VII Phase 2. Washington, DC:National Academy Press, 2006. Bryk SG ,Censullo ML, Wagner LK, Rossman LL, Cohen AM. Endovascular and interventionalprocedures in obese patients: a reviewof procedural technique modifications andradiation management. J VascInterv Radiol 2006; 17 (1): 27 – 33. Wagner LK, Archer BR, Cohen...