Purpose or learning objective
The number, variety and complexity of performed interventional procedures has increased worldwide the last two decades, leading to significantly increased patient doses (1,2). Radiation-induced effects from such procedures have been reported in the scientific literature (3,4). Many professional organizations have developed different guidelines for monitoring the fluoroscopy patient dose, identifying and follow-up patients after high-dose interventional procedures (5-9).
The purpose of the study was to prove the need of implementation of follow-up system for patients after high-dose interventional procedures. Radiation-induced effects typically are late effects,...
Methods or background
A prospective study was performed in two Interventional Cardiology Departments – A and B, on three different angiography units - A-I (2006), A-II (2009) and B-I (2015, Dose Personalization feature available). In both departments, data for all patients who underwent interventional procedures in 3-month period was collected. The dose distribution and percentage of procedures exceeding at least one of the SAFRAD trigger levels was surveyed, excluding from the analyses patients exceeding the fluoroscopy time and the number of cine-series, because of lower doses than expected....
Results or findings
Both departments regularly record all dose parameters and fluoroscopy time.
For department A, with already implemented follow-up procedure since 2014, 0.8 % (2 of 256) of all patients exceeded at least one of the trigger levels for unit I and 5.6 % (20 of 358) for unit II, compared to 11 % (32 out of 292) in the department without implemented follow-up procedure (B, unit I). For further analysis of the study results and comparison between the departments and the angiography units, Mann-Whitney U test...
Conclusion
The results of the study demonstrated that a higher frequency rate of potentially harmful fluoroscopically-guided examinations is observed in the department without implemented follow-up procedure. The implementation of a working and effective follow-up program for patients after high-dose fluoroscopy guided procedure is a quite challenging task. The development of such procedure on local level is raising the radiation protection awareness of the personnel and lowering the frequency of patients exceeding any of the SAFRAD trigger levels. The results from the survey were presented to the...
References
World Health Organization. Efficacy and radiation safety in interventional radiology. Geneva, Switzerland: World Health Organization; 2000
International Commission on Radiological Protection. Early and late effects of radiation in normal tissues and organs: threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Ann ICRP 2012;41
Koenig TR, Wolff D, Mettler FA, Wagner LK. Skin injuries from fluoroscopically guided procedures: part 1, characteristics of radiation injury. AJR Am J Roentgenol 2001;177(1):3–11
Koenig TR, Mettler FA, Wagner LK. Skin injuries from fluoroscopically guided procedures:...
Personal information and conflict of interest
D. Kostova-Lefterova:
Nothing to disclose
A. Zagorska:
Nothing to disclose
G. Dimitrov:
Nothing to disclose