Hong Chon-Seng, Chen Zhih-Cherng, Tang Kuo-Ting, Chang Wei-Ting
Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center.
Department of Pharmacy, Chia Nan University of Pharmacy and Science.
Acta Cardiol Sin. 2020 Mar;36(2):105-110. doi: 10.6515/ACS.202003_36(2).20190820A.
Avoiding unnecessary radiation exposure is the main issue during coronary angiography. Herein, we aimed to investigate whether performing coronary angioplasties with monoplane or biplane imaging most effectively reduces radiation load and shortens the procedure time.
We retrospectively enrolled 294 patients who required either coronary angiography or coronary angioplasty. They were divided into groups of only diagnostic angiography, one-, two- or three-vessel diseases. The fluoroscopy dose-area product (DAP), skin dose, fluoroscopy and procedure time were recorded.
Among the studied patients, 148 received the procedures with monoplane imaging. Compared with the radiation exposure in the monoplane group, there were significant increases in DAP and skin dose in those who received biplane imaging independently of the number of lesions. This phenomenon was also observed in the patients receiving either diagnostic angiography only or coronary interventions. In addition, there were no significant differences in contrast volume and procedure time between the monoplane and biplane groups. Notably, the average fluoroscopy time in those who received biplane imaging was significantly longer than in those who received monoplane imaging in the one- and two-vessel groups, while there were no significant differences in the diagnostic angiography only and three-vessel diseases groups.
Our findings indicated that using monoplane imaging resulted in lesser radiation exposure and similar procedure times in coronary diagnostic and interventional settings compared to using biplane imaging. This observation should be verified in prospective randomized studies.
在冠状动脉造影过程中，避免不必要的辐射暴露是主要问题。在此，我们旨在研究使用单平面或双平面成像进行冠状动脉血管成形术是否能最有效地降低辐射负荷并缩短手术时间。
我们回顾性纳入了294例需要进行冠状动脉造影或冠状动脉血管成形术的患者。他们被分为仅诊断性血管造影组、单支血管病变组、双支血管病变组或三支血管病变组。记录透视剂量面积乘积（DAP）、皮肤剂量、透视时间和手术时间。
在研究的患者中，148例接受了单平面成像手术。与单平面组的辐射暴露相比，接受双平面成像的患者，无论病变数量多少，其DAP和皮肤剂量均显著增加。在仅接受诊断性血管造影或冠状动脉介入治疗的患者中也观察到了这种现象。此外，单平面组和双平面组之间的对比剂用量和手术时间没有显著差异。值得注意的是，在单支血管病变组和双支血管病变组中，接受双平面成像的患者的平均透视时间明显长于接受单平面成像的患者，而在仅诊断性血管造影组和三支血管病变组中没有显著差异。
我们的研究结果表明，在冠状动脉诊断和介入治疗中，与使用双平面成像相比，使用单平面成像可减少辐射暴露并使手术时间相似。这一观察结果应在前瞻性随机研究中得到验证。
