Radiation exposure to children during coil occlusion of the patent ductus arteriosus

The risks of excessive exposure to ionizing radiation are well described an d measures are routinely taken to limit such exposure to both patient and p ersonnel in the catheterization laboratory. Coil occlusion of the patent du ctus arteriosus (PDA) as well as other more complex pediatric interventions has raised concern regarding radiation exposure, particularly as minimally invasive surgical techniques are being developed which lack such exposure risk. In eight consecutive patients, aged 0.7-7 years (median, 2.3 years), coil occlusion of a PDA was performed and surface entrance radiation dose d etermined by thermoluminescent dosimetry (TD), Total cumulative doses (PA lateral dose) were also calculated for each patient. Entrance and cumulati ve dose was likewise measured in 12 patients undergoing standard diagnostic catheterization (DC) and in 5 consecutive patients undergoing pulmonary ba lloon valvuloplasty (PBV). The groups were comparable in age, weight, and b ody surface area (BSA). Total cumulative dose in the PDA patients was 97 +/ - 25 mGy (mean +/- SE). There was no significant difference between the thr ee groups in entrance dose absorbed at each location or in total cumulative dose. The mean total fluoroscopy time in the PDA occlusion group was signi ficantly less than that of the PBV group (10.1 +/- 1.81 min vs, 19.3 +/- 2. 29 min, P < 0.05) but was comparable to the DC group (13.2 +/- 1.5 min, P = NS). When the subjects were analyzed collectively, no correlation between fluoroscopy time and measured entrance dose was observed. The strongest cor relates of total cumulative dose were patient weight (r = 0.67, P < 0.001) and BSA (r = 0.62, P = 0.001). Patients undergoing coil occlusion of a PDA are not exposed to increased radiation entrance dose compared to those unde rgoing standard DC and PBV. Furthermore, surface entrance radiation dose as determined by TD varies according to patient size for a given fluoroscopy time. Cathet Cardiovasc. Intervent 47:449-454, 1999. (C) 1999 Wiley-Liss, I nc.