Image noise reduction technology reduces radiation in a radial-first cardiac catheterization laboratory
journal contributionposted on 2018-06-20, 00:00 authored by A. Gunja, Y. Pandey, H. Xie, B.M. Wolska, A.R. Shroff, Amer K. Ardati, M.I. Vidovich
Background: Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting. Methods and results: We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N=200) and a new image noise reduction fluoroscopy system (N=200). The primary endpoint was radiation dose (mGy cm2). Secondary endpoints were contrast dose, fluoroscopy times, number of cineangiograms, and radiation dose by operator between the two study periods. Radiation was reduced by 44.7% between the old and new cardiac catheterization laboratory (75.8mGycm2 ±74.0 vs. 41.9mGycm2 ±40.7, p<0.0001). Radiation was reduced for both diagnostic procedures (45.9%, p<0.0001) and interventional procedures (37.7%, p<0.0001). There was no statistically significant difference in radiation dose between individual operators (p=0.84). In multivariate analysis, radiation dose remained significantly decreased with the use of the new system (p<0.0001) and was associated with weight (p<0.0001), previous coronary artery bypass grafting (p<0.0007) and greater than 3 stents used (p<0.0004). TRA was used in 90% of all cases in both periods. Compared with a transfemoral approach (TFA), TRA was not associated with higher radiation doses (p=0.20). Conclusions: Image noise reduction technology significantly reduces radiation dose in a contemporary radial-first cardiac catheterization clinical practice.
Publisher StatementNOTICE: This is the author’s version of a work that was accepted for publication in Cardiovascular Revascularization Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Cardiovascular Revascularization Medicine, 2016 DOI: 10.1016/j.carrev.2016.12.017
CitationGunja, A., Pandey, Y., Xie, H., Wolska, B. M., Shroff, A. R., Ardati, A. K. and Vidovich, M. I. Image noise reduction technology reduces radiation in a radial-first cardiac catheterization laboratory. Cardiovascular Revascularization Medicine. 2016. DOI: 10.1016/j.carrev.2016.12.017.