Background: Transcatheter aortic valve replacement (TAVR) exposes patients to radiation.
Objectives: We sought to identify factors associated with higher radiation exposure and to quantify their relative influence, which may inform reduction of this hazard.
Methods: All TAVR procedures at Rhode Island Hospital between March 20, 2012 and February 12, 2017 were included. Procedures were performed by two co-primary operators using a Siemens Artis Zeego system. Radiation metrics were generated by the imaging system. The primary metric was dose-area product (DAP, Gy*cm ), and secondary metrics were reference point air kerma (mGy) and fluoroscopy time (minutes). Data collected for the STS/ACC TVT Registry were utilized to develop a multivariable linear regression model predicting DAP.
Results: In 294 TAVRs, median DAP was 169 Gy*cm [interquartile range (IQR) 106-238]. The r values for the full 27-variable DAP model and reduced eight-variable model were 0.457 and 0.420, respectively. Valve area, aortic insufficiency, and procedure year (suggesting absence of a learning curve) were non-significant predictors in the full model, while increasing weight, cutdown transfemoral access, higher pre-procedure creatinine and hemoglobin, and vascular complications predicted higher DAP in both models. Results were unchanged when DAP was log-transformed. Secondary models for air kerma and fluoroscopy time revealed similar predictors.
Conclusion: Factors associated with increased procedural complexity and duration as well as radiation attenuation and scatter predict increased patient radiation exposure during TAVR. Modification of procedural technique, especially using percutaneous femoral vascular access, may facilitate reduction in exposure.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1002/ccd.27452 | DOI Listing |
Aerosp Med Hum Perform
November 2024
Introduction: The aviation occupational environment may expose a developing fetus to intermittent hypoxia, high gravitational force, toxic materials, loud noise, high frequency vibrations, and galactic cosmic radiation. These exposures in animal models are associated with adverse neonatal outcomes. We sought to investigate whether a maternal military aviation career was associated with adverse neonatal health outcomes.
View Article and Find Full Text PDFSkeletal Radiol
December 2024
Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02215, USA.
Objective: To compare patient radiation exposure and procedure time for lumbar epidural steroid injections (ESIs) performed under CT-fluoroscopy (CTF) vs spiral CT-guidance.
Materials And Methods: A retrospective cohort study of 767 consecutive lumbar ESIs performed between 2015-2023 using CTF vs spiral CT-guidance was conducted. Patient characteristics (age, sex, weight), procedural characteristics (injection level, type of ESI, trainee participation), and outcomes (patient radiation exposure, procedure time, pain relief, complications) were compared.
Background: Previous observational studies examining the relationship between cadmium exposure and various cancers have yielded conflicting results. This study aims to comprehensively clarify the relationship between blood cadmium concentration (BCC) and nine specific cancers.
Methods: A retrospective analysis of National Health and Nutrition Examination Survey (NHANES) 1999-2018 identified 36,991 participants.
World J Surg Oncol
December 2024
Department of Radiation Oncology, Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou, Guangdong, 510095, People's Republic of China.
Background: The combination of immunotherapy and chemotherapy has demonstrated an enhancement in progression-free survival (PFS) for individuals with advanced and metastatic triple-negative breast cancer (TNBC) when compared to the use of chemotherapy alone. Nevertheless, the extent to which different subgroups of metastatic TNBC patients experience this benefit remains uncertain.
Objectives: Our objective was to conduct subgroup analyses to more precisely identify the factors influencing these outcomes.
Biomed Eng Online
December 2024
Department of Stem Cells Technology and Tissue Regeneration, Faculty of Interdisciplinary Science and Technologies, Tarbiat Modares University, Tehran, 15614, Iran.
Chemotherapy-induced cardiotoxicity is a significant concern in cancer treatment, as certain chemotherapeutic agents can have adverse effects on the cardiovascular system. This can lead to a range of cardiac complications, including heart failure, arrhythmias, myocardial dysfunction, pericardial complications, and vascular toxicity. Strategies to mitigate chemotherapy-induced cardiotoxicity may include the use of cardioprotective agents (e.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!