RADIATION EXPOSURE - COMPARISON OF RAPID EXCHANGE AND CONVENTIONAL OVER-THE-WIRE CORONARY ANGIOPLASTY SYSTEMS

The growth of coronary angioplasty has resulted in increased fluorosco py time to patients, staff, and physicians. Rapid exchange-type cathet ers have purported to reduce fluoroscopy time and procedure time compa red to conventional over-the-wire systems. Of 150 consecutive patients , 54 were treated solely with rapid-exchange catheters and 84 were tre ated solely with over-the-wire catheters. Excluding 12 cases treated w ith fixed wire or combination catheters, the following data were found : [GRAPHICS] Overall procedural success was obtained in 98.5% (136/138 ) of patients, 1.5% (2) requiring emergency coronary artery bypass gra ft surgery. A significant 35% reduction in fluoroscopy time and 13% re duction in procedure time were found when rapid-exchange catheters wer e used, with identical success rates, number of balloons used per case , and complication rates compared to over-the-wire catheters. Rapid-ex change catheters should be considered as part of an overall effort to reduce radiation exposure in the interventional cardiology laboratory. (C) 1993 Wiley-Liss, Inc.