Radiation exposure of patients and coronary arteries in the stent era: A prospective study

Previous studies have investigated the radiation dose to doctors and patien ts during coronary angiography and angioplasty, but most of them were retro spective, conducted in the prestent era, and results have not been consiste nt. Effective dose of 57 patients undergoing coronary angiography and/or an gioplasty was assessed by using a dose-area product (DAP) to effective dose conversion factor. Radiation exposure risks to patients were then calculat ed for each procedure. Thermoluminescent dosimeters, mounted on a specially designed catheter that was advanced to the left or right sinus of Valsalva , were used to measure the dose received by the coronary arteries. Mean eff ective dose received by patients were 5.0 +/- 0.5 mSv for coronary angiogra phy, 6.6 +/- 1.0 mSv for angioplasty, 10.2 +/- 1.5 mSv for angioplasty foll owed by stent implantation, 13.6 +/- 2.5 mSv for angiography followed by ad hoc angioplasty, and 16.7 +/- 2.8 mSv for angiography followed by ad hoc a ngioplasty and stent implantation. Patient risk of developing cancer after each procedure was 0.025%, 0.033%, 0.051%, 0.068%, and 0.084%, respectively . Corresponding mean coronary irradiation doses were 24 +/- 2.5, 31.0 +/- 3 .6, 43.6 +/- 7.2, 55.0 +/- 7.5, and 64.7 +/- 5.6 mGy, respectively. A linea r relationship of the DAP and the dose at the coronary arteries was found: DAP = 1,273 (cm(2)) x coronary dose (mGy). Radiation exposure to coronary a rteries and associated risk to patients are relatively low, even following complicated, multivessel angioplasty with stent implantation. Our method ca n be used for calculation of radiation risk to patients and radiation dose to coronary arteries by using external dosimeters. Cathet. Cardiovasc. Inte rvent. 51:259-264, 2000. (C) 2000 Wiley-Liss, Inc.