Background: Exposure to high doses of radiation during cardiac interventional procedures is associated with increased rates of cataract and cancer in patients and staff members. Thus, reduction of radiation is recommended by international medical societies. The aim of this study was to evaluate, if the lowest reasonable fluoroscopic acquisition setting for electrophysiological procedures using a novel X-ray detector operated at a minimum detector entrance dose per fluoroscopy pulse is feasible and safe.
Methods: 641 consecutive patients (407 m/234f) underwent ablation procedures at our institution between August 2015 and December 2017. All ablations were performed using an Artis Q.zen X-ray system (Siemens, Germany). The first 308 patients were treated using the conventional dose program ("fluoroscopy zen standard"), from October 2016 until December 2017 another 333 patients underwent ablations using the optimized X-ray dosing program "fluoroscopy zen ULD". For the standard program fluoroscopy dose was set to 18nGy/f, for the minimized dosing program the dose was set to 6nGy/pulse and could be increased to 10 or 15 nGy/pulse manually.
Results: A total of 213 AV-node reentry tachycardia (AVNRT), 73 accessory pathways (AP), 71 atrial flutter and 284 atrial fibrillation (AF) ablation procedures were performed. Pulmonary vein isolation was performed using an electroanatomic mapping system (CARTO, Biosense Webster, USA) in 117 or a cryoballoon (Cryocath Medtronic, USA) in 167 patients. Total area dose could be reduced in all groups by a mean of 74.7% (4201.4μGym² vs. 1063.7μGym²), with a relative reduction of 73.1% for left atrial and 78.0% for right sided ablations. Total fluoroscopy time, procedure duration, acute ablation success, recurrence rate and complications remained unchanged.
Conclusion: Fluoroscopy dose could be significantly reduced using an optimized X-ray dosing program in a novel X-ray detector without increasing total fluoroscopy time and without alterations of the incidence of recurrences or complications.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.ejrad.2018.11.019 | DOI Listing |
Int Urol Nephrol
January 2025
Department of Urology, MedStar Georgetown, Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC, 20007, USA.
Introduction: Radiation exposure during percutaneous nephrolithotomy (PCNL) can vary depending on the method used for renal access. This study aimed to compare fluoroscopy time and dose during PCNL when renal access is achieved via interventional radiology (IR) versus urology.
Methods: A retrospective review of patients who underwent unilateral PCNL between January 2020 and February 2023 was conducted.
Am Heart J
January 2025
Department of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian, New York, NY 10032.
Background: This retrospective study addresses the role of operator and fluoroscopy equipment in reducing patient radiation exposure in the Cath lab.
Methods: Data from 99,400 procedures performed in our institution between 2007 and 2019 were reviewed. Dosimetric parameters included reference point air kerma (K), Kerma Area Product (P), fluoroscopic time, and contrast volume.
Eur J Radiol
January 2025
Department of Stereotactic and Functional Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, 79106 Freiburg, Germany; Fraunhofer Institute for Laser Technology (ILT), 52074 Aachen, Germany.
Purpose: Directional deep brain stimulation (dDBS) relies on electrodes steering the stimulation field in a specific direction. Post implantation, however, the intended and real orientation of the lead frequently deviates e.g.
View Article and Find Full Text PDFJ Med Imaging Radiat Sci
January 2025
Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Rua 5 de Outubro, S. Martinho do Bispo, Coimbra 3046-854, Portugal. Electronic address:
Background: Currently, there is an increase in procedures across various clinical specialties involving the use of ionising radiation.
Objective: The primary objective of this systematic review is to analyse and compare the existing literature regarding the effectiveness of leaded glasses for healthcare professionals.
Methods: Comprehensive literature searches were conducted for relevant studies published between 2018 and 2023 using the Scopus, PubMed, and Web of Science databases according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology.
Surg Technol Int
January 2025
JIS Orthopedics Inc., New Albany, Ohio.
Accurate acetabular component positioning is crucial for the success of total hip arthroplasty (THA). Malplacement of the acetabular component increases the risk of post-surgery complications, most notably dislocation.1 Furthermore, malposition can also result in wear of the polyethylene liner, limited range of motion, and osteolysis.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!