Experience with a portable digital C-arm system for cardiac catheterization and intervention

Recently, portable C-arm systems have been developed for cardiac studies. W hile these systems have been used at a number of centers on a small scale f or procedures in the operating room, emergency room, or intensive care unit , there are no published data on theperformance of the system under more de manding circumstances. Theoretically, a reliable portable C-arm system coul d provide a low-cost alternative to a fixed system in centers with limited resources, such as in developing countries. To test whether a portable C-ar m system could substitute for a permanent laboratory for cardiac catheteriz ation and interventional procedures, we used a C-arm system as our sole cat heterization laboratory for a period of 3 months. The system's performance was compared to a comparable time period using a fixed catheterization labo ratory system. The portable system was used to perform 222 procedures (36 i nterventional and 186 diagnostic) as compared to 236 procedures (30 interve ntional and 206 diagnostic) with the fixed lab during a comparable time per iod the preceding year: Although the image quality of the portable system w as not as good as with the fixed laboratory, all procedures were performed successfully, with no difference in fluoroscopic time, radiation exposure t o the patient, procedure related complications, or clinical restenosis at 1 year. However, radiation exposure to staff was greater, possibly due to th e lack of shielding in the temporary lab and the need for the technician to remain close to the unit to set up views. Our results suggest that a porta ble C-arm system, while subject to some limitations, can perform as a gener al catheterization laboratory for diagnostic and interventional procedures.