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1 Department of Bioengineering, Onassis Cardiac Surgery Centre, Athens, 2 Medical Physics Department, Athens University, Medical School, Athens, Greece, 3 Medical Physics Service and Radiology Department, San Carlos University Hospital and Complutense University, Madrid, Spain, 4 Quality Assurance Reference Centre, Newcastle General Hospital, Newcastle upon Tyne, UK, 5 Medical Physics Department, Regional Athens General Hospital "G.Gennimatas", Athens, Greece, and 6 Servizio di Fisica, Ospedale S. Maria della Misericardia, 33100 Udine, Italy
The purpose of this study was to collect information on the practice and patient doses in a major Greek cardiac centre, investigate differences between senior cardiologists of various levels of experience and compare results with the literature, in order to optimize angiographic and interventional cardiology procedures. Radiation doses from 292 patients have been studied, 195 of which had undergone coronary angiography and 97 percutaneous transluminal coronary angioplasty. All procedures were undertaken on a Siemens Angioscop X-ray equipment. The system performed under automatic exposure control using pulsed fluoroscopy of 12.5 pulses s-1 and cine frame rate of 25 frames s-1. Dose–area product values, fluoroscopy times, total number of cine frames as well as operator's name were collected for each patient. Only senior cardiologists have participated in the study. Median values for dose–area product were 39.1 Gy cm2 for coronary angiography and 58.3 Gy cm2 for percutaneous transluminal coronary angioplasty. Median fluoroscopy time was 5.0 min and 9.7 min and median number of frames was 1588 and 1823 for coronary angiography and percutaneous transluminal coronary angioplasty, respectively. Comparison showed that patient dose–area product values were lower than other studies and fluoroscopy time values were comparable. However, the total number of frames used was much higher than other published results. Differences between cardiologists with increased experience have been found. Analysis of the patient dose values obtained initiated a program of radiation protection optimization. The need for continuous training in radiation protection for interventionalists has been verified.
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