Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama-city, Saitama, 330-8503 Japan.
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama-city, Saitama, 330-8503 Japan.
J Cardiol. 2020 Aug;76(2):217-223. doi: 10.1016/j.jjcc.2020.02.021. Epub 2020 Mar 17.
Peak skin dose (PSD) is closely associated with skin radiation injuries such as skin ulcers in percutaneous coronary intervention (PCI). Although PSD is greater in PCI for chronic total occlusion (CTO) lesions as compared with non-CTO lesions, the determinants of PSD in CTO-PCI are not fully understood. The purpose of this study was to investigate the clinical factors associated with excess PSD in PCI for CTO.
The study population included a total of 220 CTO-PCI cases that were divided into a standard PSD group (<2 Gy, n = 187) and an excess PSD group (≥2 Gy, n = 33). Clinical, lesion, and procedural characters were compared between the 2 groups. Multivariate logistic regression was performed to investigate the clinical factors associated with excess PSD.
Body surface area (BSA) was significantly higher in the excess PSD group (1.85 ± 0.24 m) than the standard PSD group (1.71 ± 0.18 m) (p = 0.001). The J-CTO score was significantly higher in the excess PSD group (2.51 ± 1.28) than the standard PSD group (1.60 ± 1.13) (p < 0.001). Multivariate logistic regression analysis revealed that BSA (0.1 mm increase: OR 1.663, 95% CI 1.300-2.128, p < 0.001) and J-CTO score (1-point increase: OR 2.015, 95% CI 1.322-3.071, p = 0.001) were significantly associated with excess PSD.
A large BSA and high J-CTO score were significantly associated with excess PSD. It is important to pay special attention to CTO patients who have a large BSA and/or high J-CTO score to reduce patient's PSD.
峰值皮肤剂量（PSD）与经皮冠状动脉介入治疗（PCI）中的皮肤溃疡等皮肤辐射损伤密切相关。虽然与非慢性完全闭塞（CTO）病变相比，慢性完全闭塞（CTO）病变的 PCI 中的 PSD 更大，但 CTO-PCI 中 PSD 的决定因素尚不完全清楚。本研究旨在探讨与 CTO-PCI 中 PSD 过高相关的临床因素。
研究人群包括 220 例 CTO-PCI 病例，分为标准 PSD 组（<2 Gy，n=187）和 PSD 过高组（≥2 Gy，n=33）。比较两组的临床、病变和操作特征。采用多变量 logistic 回归分析探讨与 PSD 过高相关的临床因素。
PSD 过高组的体表面积（BSA）明显高于标准 PSD 组（1.85±0.24 m 比 1.71±0.18 m）（p=0.001）。PSD 过高组的 J-CTO 评分明显高于标准 PSD 组（2.51±1.28 比 1.60±1.13）（p<0.001）。多变量 logistic 回归分析显示，BSA（每增加 0.1mm：OR 1.663，95%CI 1.300-2.128，p<0.001）和 J-CTO 评分（增加 1 分：OR 2.015，95%CI 1.322-3.071，p=0.001）与 PSD 过高显著相关。
大 BSA 和高 J-CTO 评分与 PSD 过高显著相关。对于 BSA 较大和/或 J-CTO 评分较高的 CTO 患者，特别要注意降低患者的 PSD。
