Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol

Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic proce...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Seiffert, Moritz [verfasserIn] Ojeda, Francisco [verfasserIn] Müllerleile, Kai [verfasserIn] Zengin, Elvin [verfasserIn] Sinning, Christoph [verfasserIn] Waldeyer, Christoph [verfasserIn] Lubos, Edith [verfasserIn] Schäfer, Ulrich [verfasserIn] Sydow, Karsten [verfasserIn] Blankenberg, Stefan [verfasserIn] Westermann, Dirk [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2015

Schlagwörter:	Radiation Percutaneous coronary interventions

Übergeordnetes Werk:	Enthalten in: Zeitschrift für Kardiologie - Darmstadt : Steinkopff, 1997, 104(2015), 6 vom: 22. Jan., Seite 500-506
Übergeordnetes Werk:	volume:104 ; year:2015 ; number:6 ; day:22 ; month:01 ; pages:500-506

Links:	Volltext

DOI / URN:	10.1007/s00392-015-0814-7

Katalog-ID:	SPR004810953

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520			\|a Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards.
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allfields	10.1007/s00392-015-0814-7 doi (DE-627)SPR004810953 (SPR)s00392-015-0814-7-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Seiffert, Moritz verfasserin aut Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards. Radiation (dpeaa)DE-He213 Percutaneous coronary interventions (dpeaa)DE-He213 Ojeda, Francisco verfasserin aut Müllerleile, Kai verfasserin aut Zengin, Elvin verfasserin aut Sinning, Christoph verfasserin aut Waldeyer, Christoph verfasserin aut Lubos, Edith verfasserin aut Schäfer, Ulrich verfasserin aut Sydow, Karsten verfasserin aut Blankenberg, Stefan verfasserin aut Westermann, Dirk verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 104(2015), 6 vom: 22. Jan., Seite 500-506 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:104 year:2015 number:6 day:22 month:01 pages:500-506 https://dx.doi.org/10.1007/s00392-015-0814-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 104 2015 6 22 01 500-506
spelling	10.1007/s00392-015-0814-7 doi (DE-627)SPR004810953 (SPR)s00392-015-0814-7-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Seiffert, Moritz verfasserin aut Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards. Radiation (dpeaa)DE-He213 Percutaneous coronary interventions (dpeaa)DE-He213 Ojeda, Francisco verfasserin aut Müllerleile, Kai verfasserin aut Zengin, Elvin verfasserin aut Sinning, Christoph verfasserin aut Waldeyer, Christoph verfasserin aut Lubos, Edith verfasserin aut Schäfer, Ulrich verfasserin aut Sydow, Karsten verfasserin aut Blankenberg, Stefan verfasserin aut Westermann, Dirk verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 104(2015), 6 vom: 22. Jan., Seite 500-506 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:104 year:2015 number:6 day:22 month:01 pages:500-506 https://dx.doi.org/10.1007/s00392-015-0814-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 104 2015 6 22 01 500-506
allfields_unstemmed	10.1007/s00392-015-0814-7 doi (DE-627)SPR004810953 (SPR)s00392-015-0814-7-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Seiffert, Moritz verfasserin aut Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards. Radiation (dpeaa)DE-He213 Percutaneous coronary interventions (dpeaa)DE-He213 Ojeda, Francisco verfasserin aut Müllerleile, Kai verfasserin aut Zengin, Elvin verfasserin aut Sinning, Christoph verfasserin aut Waldeyer, Christoph verfasserin aut Lubos, Edith verfasserin aut Schäfer, Ulrich verfasserin aut Sydow, Karsten verfasserin aut Blankenberg, Stefan verfasserin aut Westermann, Dirk verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 104(2015), 6 vom: 22. Jan., Seite 500-506 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:104 year:2015 number:6 day:22 month:01 pages:500-506 https://dx.doi.org/10.1007/s00392-015-0814-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 104 2015 6 22 01 500-506
allfieldsGer	10.1007/s00392-015-0814-7 doi (DE-627)SPR004810953 (SPR)s00392-015-0814-7-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Seiffert, Moritz verfasserin aut Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards. Radiation (dpeaa)DE-He213 Percutaneous coronary interventions (dpeaa)DE-He213 Ojeda, Francisco verfasserin aut Müllerleile, Kai verfasserin aut Zengin, Elvin verfasserin aut Sinning, Christoph verfasserin aut Waldeyer, Christoph verfasserin aut Lubos, Edith verfasserin aut Schäfer, Ulrich verfasserin aut Sydow, Karsten verfasserin aut Blankenberg, Stefan verfasserin aut Westermann, Dirk verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 104(2015), 6 vom: 22. Jan., Seite 500-506 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:104 year:2015 number:6 day:22 month:01 pages:500-506 https://dx.doi.org/10.1007/s00392-015-0814-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 104 2015 6 22 01 500-506
allfieldsSound	10.1007/s00392-015-0814-7 doi (DE-627)SPR004810953 (SPR)s00392-015-0814-7-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.67 bkl 44.85 bkl Seiffert, Moritz verfasserin aut Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards. Radiation (dpeaa)DE-He213 Percutaneous coronary interventions (dpeaa)DE-He213 Ojeda, Francisco verfasserin aut Müllerleile, Kai verfasserin aut Zengin, Elvin verfasserin aut Sinning, Christoph verfasserin aut Waldeyer, Christoph verfasserin aut Lubos, Edith verfasserin aut Schäfer, Ulrich verfasserin aut Sydow, Karsten verfasserin aut Blankenberg, Stefan verfasserin aut Westermann, Dirk verfasserin aut Enthalten in Zeitschrift für Kardiologie Darmstadt : Steinkopff, 1997 104(2015), 6 vom: 22. Jan., Seite 500-506 (DE-627)254911137 (DE-600)1463330-9 1435-1285 nnns volume:104 year:2015 number:6 day:22 month:01 pages:500-506 https://dx.doi.org/10.1007/s00392-015-0814-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 44.67 ASE 44.85 ASE AR 104 2015 6 22 01 500-506
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Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. 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author	Seiffert, Moritz
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topic_title	610 ASE 44.67 bkl 44.85 bkl Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol Radiation (dpeaa)DE-He213 Percutaneous coronary interventions (dpeaa)DE-He213
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title	Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol
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title_full	Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol
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author_browse	Seiffert, Moritz Ojeda, Francisco Müllerleile, Kai Zengin, Elvin Sinning, Christoph Waldeyer, Christoph Lubos, Edith Schäfer, Ulrich Sydow, Karsten Blankenberg, Stefan Westermann, Dirk
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title_sort	reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol
title_auth	Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol
abstract	Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards.
abstractGer	Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards.
abstract_unstemmed	Background With an increasing number of complex and repeated percutaneous coronary interventions (PCI), radiation-induced hazards for patients and operators remain an important issue in fluoroscopy-guided procedures. Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. Hence, radiation safety programs are of paramount importance and should be established to improve patient and operator safety with regard to radiation-induced hazards.
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title_short	Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol
url	https://dx.doi.org/10.1007/s00392-015-0814-7
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author2	Ojeda, Francisco Müllerleile, Kai Zengin, Elvin Sinning, Christoph Waldeyer, Christoph Lubos, Edith Schäfer, Ulrich Sydow, Karsten Blankenberg, Stefan Westermann, Dirk
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up_date	2024-07-04T02:41:12.868Z
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Our objective was to evaluate radiation exposure during coronary angiographic procedures and assess the efficacy of a four-step program to reduce radiation exposure during coronary angiography (CAG) and PCI. Methods and results A retrospective single-center analysis was performed in patients undergoing CAG or PCI in the first 6 months of 2012 vs. the first 6 months of 2014 (n = 3,107 procedures). During 2013, a four-step protocol was established in our hospital. It contained measures to reduce radiation exposure, including a frame rate reduction from 15 to 7.5 frames per second, the use of fluoroscopy storage, strict use of beam collimation, and repeat training on radiation safety. After adjustment for confounding variables, a dose-area product (DAP) reduction of 54.2 % was observed subsequent to implementation of the four-step protocol. Independent predictors of DAP were age [odds ratio (OR) 1.01], body surface area (OR 5.47), prior coronary artery bypass grafting (OR 1.44), radial access (OR 1.16), PCI (OR 2.36), female gender (OR 0.91), and the implementation of the four-step program (OR 0.46). Conclusion A simple four-step protocol led to a significant reduction in radiation exposure in diagnostic and interventional coronary procedures without significant drawbacks in image quality. 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Reducing radiation exposure during invasive coronary angiography and percutaneous coronary interventions implementing a simple four-step protocol

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