USE OF A REMOTELY CONTROLLED MECHANICAL PUMP FOR CORONARY ARTERIOGRAPHY - A STUDY OF RADIATION EXPOSURE AND QUALITY IMPLICATIONS

Background-Exposure to radiation is a hazard of invasive cardiology. T o minimise the risk it is essential to keep the doses received as low as possible. Aim-To assess the effect on cardiologist radiation exposu re and the quality of coronary artery opacification of the use of a re motely controlled mechanical pump for coronary arteriography. A second ary aim was to assess any disadvantages and safety. Methods-319 patien ts were randomised to have coronary arteriography carried out with con trast injected either by hand or by a remotely controlled mechanical p ump. Six cardiologists participated: two catheter laboratories were us ed and both brachial and femoral approaches were included. The exposur e of the cardiologists to radiation was assessed by film badge dosimet ry. The badges were worn on the hat. The total time for the procedure, screening time, the dose-area product meter reading, and any complica tions were recorded for each examination. The quality of arterial opac ification was reported on a scale of 0-5. Results-The mean radiation d ose per procedure was 0.011 mSv for hand injection of contrast and 0.0 05 mSv for mechanical injection (p < 0.01). There were no differences in procedure times or screening times. There were no complications att ributable to mechanical injection. Arterial opacification was not sign ificantly different in the two groups (4.01 v 4.03 for the left corona ry artery, 4.68 v 4.78 for the right coronary artery). The right coron ary artery was consistently better opacified than the left by both tec hniques (4.59 v 3.89, p < 0.001). Conclusions-Use of a remotely contro lled mechanical pump for coronary arteriography reduced cardiologist r adiation exposure by half. It was not associated with any inconvenienc e, expense, or complications and produced arterial opacification at le ast as good as injection by hand.