School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.
Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Sci Rep. 2023 Feb 10;13(1):2391. doi: 10.1038/s41598-023-28704-y.
The number and complexity of transcatheter procedures continue to increase, raising concerns regarding radiation exposure to patients and staff. Procedures such as transaortic valve implantations (TAVI) have led to cardiologists adopting higher dose techniques, such as digital subtraction angiography (DSA). This study compared the estimated patient and occupational eye dose during coronary angiography (CA), percutaneous coronary intervention (PCI), TAVI workups (TWU), TAVI, endovascular aneurysm repairs (EVAR), and other peripheral diagnostic (VD) and interventional (VI) vascular procedures. A quantitative analysis was performed on patient dose during 299 endovascular and 1498 cardiac procedures. Occupational dose was measured for the cardiologists (n = 24), vascular surgeons (n = 3), scrub (n = 32) and circulator nurses (n = 35). TAVI and EVAR were associated with the highest average dose for all staff, and significantly higher patient dose area product, probably attributable to the use of DSA. Scrub nurses were exposed to higher average doses than the operator and scout nurse during CA, VD and VI. Circulating nurses had the highest average levels of exposure during TAVI. This study has demonstrated that EVAR and TAVI have similar levels of occupational and patient dose, with a notable increase in circulator dose during TAVI. The use of DSA during cardiac procedures is associated with an increase in patient and staff dose, and cardiologists should evaluate whether DSA is necessary. Scrub nurses may be exposed to higher levels of occupational dose than the operator.
经导管治疗的数量和复杂性不断增加，这引起了人们对患者和医护人员辐射暴露的关注。经主动脉瓣植入术（TAVI）等手术促使心脏病专家采用更高剂量的技术，如数字减影血管造影（DSA）。本研究比较了冠状动脉造影（CA）、经皮冠状动脉介入治疗（PCI）、TAVI 术前评估（TWU）、TAVI、血管内动脉瘤修复（EVAR）以及其他外周诊断（VD）和介入（VI）血管程序期间，估计的患者和职业眼部剂量。对 299 例血管内和 1498 例心脏手术期间的患者剂量进行了定量分析。测量了 24 名心脏病专家、3 名血管外科医生、32 名洗手护士和 35 名巡回护士的职业剂量。TAVI 和 EVAR 与所有工作人员的平均最高剂量相关，并且患者剂量面积产品显著更高，这可能归因于 DSA 的使用。在 CA、VD 和 VI 期间，洗手护士的平均剂量高于术者和透视护士。在 TAVI 期间，巡回护士的平均暴露水平最高。本研究表明，EVAR 和 TAVI 的职业和患者剂量水平相似，但 TAVI 期间巡回护士的剂量明显增加。在心脏手术中使用 DSA 会增加患者和工作人员的剂量，心脏病专家应评估 DSA 是否必要。洗手护士的职业暴露剂量可能高于术者。
