DOES THE USE OF NEW INTRACORONARY INTERVENTIONAL DEVICES PROLONG RADIATION EXPOSURE IN THE CARDIAC-CATHETERIZATION LABORATORY

Objectives. The aim of this study was to compare the duration of radia tion exposure associated with new percutaneous coronary interventional devices with that associated with conventional balloon angioplasty. B ackground. Radiation exposure levels have been documented to be higher with coronary balloon angioplasty than with routine diagnostic corona ry angiography. However, the effect of new interventional devices on r adiation exposure has not been studied. Methods. Fluoroscopic and cine angiographic data from the Mayo Clinic cardiac catheterization laborat ory data base of patients having single-segment coronary intervention during a recent 46-month period were retrospectively analyzed. Of 897 patients studied, 646 underwent balloon angioplasty, 138 directional c oronary atherectomy (42 with adjunctive balloon angioplasty), 76 excim er laser angioplasty (50 with adjunctive balloon angioplasty) and 37 p lacement of an intracoronary stent (16 emergencies). Results. Duration of fluoroscopy during balloon angioplasty was 24 +/- 18 min, which wa s longer than with directional atherectomy (18 +/- 8 min; p = 0.001). Fluoroscopy time was 25 +/- 17 min with laser angioplasty and 29 +/- 1 5 min with elective stent placement (neither time was significantly di fferent from that with balloon angioplasty). When atherectomy or laser angioplasty was performed with adjunctive balloon angioplasty or if e mergency intracoronary stent placement was performed, the duration of fluoroscopy was significantly prolonged compared with balloon angiopla sty alone. Conclusions. Fluoroscopy duration is not prolonged with the use of new interventional coronary devices compared with conventional angioplasty unless adjunctive balloon angioplasty is used or emergenc y stent placement is required.