Coronary angiography and percutaneous transluminal coronary angioplasty procedures: Evaluation of patients' maximum skin dose using Gafchromic films and a comparison of local levels with reference levels proposed in the literature |
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| Authors: | C Giordano L D'Ercole R Gobbi M Bocchiola F Passerini |
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| Institution: | 1. Department of Medical Physics, AUSL di Piacenza, 29100 Piacenza, Italy;2. Department of Medical Physics, Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Italy;3. Department of Cardiology, AUSL di Piacenza, 29100 Piacenza, Italy;1. Department of Cardiology, University Health Network, Toronto, Canada;2. Department of Cardiology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, UK;3. Department of Cardiology, East Carolina University, Greenville, NC, USA;4. Department of Cardiology, Ysybty Gwynedd, Betsi Cadwaladr University Health Board, UK;1. Faculty of Pharmacy, Siam University, 38 Petkasem Road, Bangkok 10160, Thailand;2. Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhya Road, Bangkok 10400, Thailand;1. Korea Aerospace Research Institute, Republic of Korea;2. KARI, Republic of Korea;3. Chungnam National University, Republic of Korea;4. Korea Aerospace University, Republic of Korea;1. IRCCS-I stituto di Ricerche Farmacologiche Mario Negri, Via La Masa 19, Milano, Italy;2. University of Ni?, Faculty of Medicine, Department of Chemistry, Ni?, Serbia;3. Interdisciplinary Nanotoxicity Center, Department of Civil and Environmental Engineering, Jackson State University, 1325 Lynch St, Jackson, MS 39217-0510, USA;4. Interdisciplinary Nanotoxicity Center, Department of Chemistry and Biochemistry, Jackson State University, 1400 J. R. Lynch Street, P.O. Box 17910, Jackson, MS 39217, USA;1. Department of Chemistry, Islamic Azad University, Shahre Rey Branch, Tehran, Iran;2. Department of Chemistry, University of Tehran, Tehran, Iran;3. Center of Excellence in Electrochemistry, Faculty of Chemistry, University of Tehran, Tehran, Iran;4. Department of Chemistry, Alzahra University, Tehran, Iran;1. Department of Physicochemical Drug Analysis, Chair of Pharmaceutical Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland;2. Chair of Pharmacodynamics, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland;3. Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München, Butenandtstr. 5-13, 81377 Munich, Germany |
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| Abstract: | The aim of this study was to evaluate the maximum skin dose (MSD) in patients undergoing interventional cardiology procedures, obtaining local reference levels and comparing these with the reference levels proposed in the literature.The patients' MSD was measured using Gafchromic XR type R films. In order to evaluate reference levels, the number of images acquired, the fluoroscopy times and the KAPTOTAL were recorded for each procedure.For the evaluation of the MSD, 8 coronary angiography (CA) and 16 percutaneous transluminal coronary angioplasty (PTCA) procedures, carried out in the period from May to June 2008, were analyzed.For the CA procedures the MSD values were below 0.5 Gy.For the PTCA procedures, we found a fairly good correlation between fluoroscopy time and MSD (r = 0.80, p = 0.0002) and between MSD and WFP (r = 0.863, p < 0.0001); there was a strong correlation between KAPTOTAL and MSD (r = 0.904, p < 0.0001). Since the correlation between KAPTOTAL and MSD is more striking than that with fluoroscopic time and the WFP, KAP measurements are suitable for online skin dosimetry and may, therefore, be used to avoid radiation-induced skin injuries. A MSD greater than 3 Gy occurred in only one procedure.For calculus of the local reference levels, we extended the data-gathering to 30 procedure CA and to 40 PTCA: we compared local practice with that in other centers using the guidance levels proposed by Balter et al. Our median KAP values were below these proposed guidance levels; our mean KAP values were above these proposed action levels. From a first application of the proposed reference levels, it appears that, according to the recommendations of Balter et al. an investigation into local practice is not necessary. |
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