Katritsis D, Efstathopoulos E, Betsou S, Korovesis S, Faulkner K, Panayiotakis G, Webb-Peploe M M
Department of Cardiology, Athens Euroclinic, Athens, Greece.
Catheter Cardiovasc Interv. 2000 Nov;51(3):259-64. doi: 10.1002/1522-726x(200011)51:3<259::aid-ccd2>3.0.co;2-i.
Previous studies have investigated the radiation dose to doctors and patients during coronary angiography and angioplasty, but most of them were retrospective, conducted in the prestent era, and results have not been consistent. Effective dose of 57 patients undergoing coronary angiography and/or angioplasty was assessed by using a dose-area product (DAP) to effective dose conversion factor. Radiation exposure risks to patients were then calculated for each procedure. Thermoluminescent dosimeters, mounted on a specially designed catheter that was advanced to the left or right sinus of Valsalva, were used to measure the dose received by the coronary arteries. Mean effective dose received by patients were 5.0 +/- 0.5 mSv for coronary angiography, 6.6 +/- 1.0 mSv for angioplasty, 10.2 +/- 1.5 mSv for angioplasty followed by stent implantation, 13.6 +/- 2.5 mSv for angiography followed by ad hoc angioplasty, and 16.7 +/- 2.8 mSv for angiography followed by ad hoc angioplasty and stent implantation. Patient risk of developing cancer after each procedure was 0.025%, 0.033%, 0.051%, 0.068%, and 0.084%, respectively. Corresponding mean coronary irradiation doses were 24 +/- 2.5, 31.0 +/- 3.6, 43.6 +/- 7.2, 55.0 +/- 7.5, and 64.7 +/- 5.6 mGy, respectively. A linear relationship of the DAP and the dose at the coronary arteries was found: DAP = 1,273 (cm(2)) x coronary dose (mGy). Radiation exposure to coronary arteries and associated risk to patients are relatively low, even following complicated, multivessel angioplasty with stent implantation. Our method can be used for calculation of radiation risk to patients and radiation dose to coronary arteries by using external dosimeters. Cathet. Cardiovasc. Intervent. 51:259-264, 2000.
以往的研究调查了冠状动脉造影和血管成形术期间医生和患者所接受的辐射剂量，但其中大多数研究是回顾性的，在支架植入前时代进行，且结果并不一致。通过使用剂量面积乘积（DAP）与有效剂量转换因子来评估57例接受冠状动脉造影和/或血管成形术患者的有效剂量。然后针对每个操作计算患者的辐射暴露风险。将热释光剂量计安装在一根专门设计的导管上，该导管推进至左或右瓦尔萨尔瓦窦，用于测量冠状动脉所接受的剂量。冠状动脉造影患者所接受的平均有效剂量为5.0±0.5毫希沃特，血管成形术为6.6±1.0毫希沃特，血管成形术加支架植入为10.2±1.5毫希沃特，冠状动脉造影加临时血管成形术为13.6±2.5毫希沃特，冠状动脉造影加临时血管成形术和支架植入为16.7±2.8毫希沃特。每个操作后患者患癌风险分别为0.025%、0.033%、0.051%、0.068%和0.084%。相应的冠状动脉平均照射剂量分别为24±2.5、31.0±3.6、43.6±7.2、55.0±7.5和64.7±5.6毫戈瑞。发现DAP与冠状动脉剂量之间存在线性关系：DAP = 1273（平方厘米）×冠状动脉剂量（毫戈瑞）。即使在进行复杂的多支血管血管成形术并植入支架后，冠状动脉的辐射暴露以及对患者的相关风险也相对较低。我们的方法可用于通过使用外部剂量计计算患者的辐射风险和冠状动脉的辐射剂量。《心血管介入导管术》51:259 - 264，2000年。
