Department of Cardiology, Belfast Health and Social Care Trust, c/o Level 9, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, Northern, Ireland.
Department of Cardiology, Edinburgh Royal Infirmary, Edinburgh, Scotland.
Catheter Cardiovasc Interv. 2018 Sep 1;92(3):E254-E261. doi: 10.1002/ccd.27541. Epub 2018 Feb 7.
A retrospective study was performed to investigate if the generation of X-ray system used was an independent factor for radiation dose in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
PCI procedures for CTOs are known to be associated with higher doses of radiation. The authors suspected progressive reductions in radiation doses for CTO PCI as newer X-ray systems were introduced into clinical practice.
Procedures performed over a five-year period by three interventional cardiologists were retrospectively reviewed. Five different X-ray systems were used across three hospital sites. These included: Axiom Artis and Coroskop HIP (both Siemens), Innova (GE), Allura Xper FD 10, and Allura Clarity FD 10 (both Philips). Procedural and demographic data including body mass index (BMI; kg/m ), fluoroscopy time (min), and dose area product (DAP; cGycm ) were collated for each procedure. Statistical analysis was performed to compare the influence each X-ray system would have on DAP values after BMI and fluoroscopy time were controlled for.
In total, 860 procedures were analyzed. Mean fluoroscopy time was 40.00 ± 19.99 min, mean BMI was 29.90 ± 5.13 kg/m , mean DAP 11,980 ± 7,947 cGycm . Log values of DAP were used to normalize results in a general linear model. A significant statistical difference in DAP between X-ray systems was demonstrated after fluoroscopy time and BMI were controlled for (P ≤ 0.001).
There is a significant impact on DAP values resulting from the generation of X-ray system used, measured during PCI for CTOs, with the most modern systems producing the lowest radiation doses.
本回顾性研究旨在探讨 X 射线系统的类型是否为慢性完全闭塞（CTO）经皮冠状动脉介入治疗（PCI）中辐射剂量的独立影响因素。
已知 CTO 的 PCI 操作与更高剂量的辐射相关。作者推测，随着新型 X 射线系统在临床实践中的应用，CTO PCI 的辐射剂量逐渐降低。
回顾性分析三位介入心脏病专家在五年期间进行的手术。在三个医院站点使用了五种不同的 X 射线系统：Axiom Artis 和 Coroskop HIP（均为西门子）、Innova（GE）、Allura Xper FD10 和 Allura Clarity FD10（均为飞利浦）。收集了每个手术的程序和人口统计学数据，包括体重指数（BMI；kg/m ）、透视时间（min）和剂量面积乘积（DAP；cGycm ）。进行了统计学分析，以比较在控制 BMI 和透视时间后，每种 X 射线系统对 DAP 值的影响。
共分析了 860 例手术。平均透视时间为 40.00±19.99 min，平均 BMI 为 29.90±5.13 kg/m ，平均 DAP 为 11980±7947 cGycm 。对数 DAP 值用于在一般线性模型中归一化结果。在控制透视时间和 BMI 后，X 射线系统之间的 DAP 存在显著统计学差异（P≤0.001）。
在 CTO 的 PCI 中，X 射线系统的类型对 DAP 值有显著影响，最新型系统产生的辐射剂量最低。
