Patient exposure data and operator dose in coronary interventional procedures: Impact of body-mass index and procedure complexity.

Purpose: The aim of this study was to assess patient exposure data and operator dose in coronary interventional procedures, when considering patient body-mass index and procedure complexity.

Methods: Total air kerma area product (P), Air-Kerma (AK), Fluoroscopy time (FT), operator dose and patient body-mass index (BMI) from 97 patients' procedures (62 coronary angiography (CA) and 35 Percutaneous Coronary Intervention (PCI) were collected for one year. For PCI procedures, also the complexity index-CI was collected. Continuous variables for each of the 2 groups procedures (CA and PCI) were compared as medians with interquartile range and using Mann-Whitney U test. Multiple group data were compared using Kruskal-Wallis test (significance: p < 0.05).

Results: Median P was 63 and 125 Gy cm for CA and PCI respectively (p < 0.001); FT was 3 and 14 min, respectively (p < 0.001). P and FT significantly increased (p < 0.05) with BMI class for CA procedures. P and FT also increased in function of CI class for PCI, thought significantly only for FT (p < 0.001), possibly because of the low number of PCI procedures included; cine mode contributed most to P. Significant dose variability was observed among cardiologists for CA procedures (p < 0.001).

Conclusions: Dose references levels for P and FT in interventional cardiology should be defined - on a sufficient number of procedures- in function of CI and BMI classes. These could provide an additional tool for refining a facility's quality assurance and optimization processes. Dose variability associated with cardiologists underlines the importance of continuous training.