Document Detail

Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure.
MedLine Citation:
PMID:  23150118     Owner:  NLM     Status:  Publisher    
PURPOSE: To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MATERIALS AND METHODS: MESD were evaluated with radiochromic films in 31 patients (mean age 72 ± 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 ± 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. RESULTS: MESD values (mean 0.96 ± 0.42 Gy) were <2 Gy without relevant dependence on procedure complexity. Local DRL values for kerma area product (KAP), fluoroscopy time (FT), and number of frames (N(FR)) were 269 Gy cm(2), 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1-102.7, p < 0.05) and N(FR) overexposures (OR 10.8, 95 % CI 1.1-109.5, p < 0.05). Type I aortic arch decreased the risk of FT overexposure (OR 0.4, 95 % CI 0.1-0.9, p = 0.042), and stenosis ≥ 90 % increased the risk of N(FR) overexposure (OR 2.8, 95 % CI 1.1-7.4, p = 0.040). At multivariable analysis, stenosis ≥ 90 % (OR 2.8, 95 % CI 1.1-7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1-109.5, p = 0.027) were associated with overexposure for two or more parameters. CONCLUSION: Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.
Loredana D'Ercole; Pietro Quaretti; Nicola Cionfoli; Catherine Klersy; Milena Bocchiola; Giuseppe Rodolico; Andrea Azzaretti; Francesco Lisciandro; Tommaso Cascella; Federico Zappoli Thyrion
Related Documents :
18713488 - Body composition in psychotic disorders: a general population survey.
19473178 - Distribution of plasma levels of adiponectin and leptin in an adult caucasian population.
11850748 - Is adiposity at normal body weight relevant for cardiovascular disease risk?
18442078 - Nutrition transition in amazonia: obesity and socioeconomic change in the suruí indian...
17286068 - Erosive vulvar lichen planus: retrospective review of characteristics and outcomes in 1...
22917638 - The current state of indigenous and aboriginal women with diabetes in pregnancy: a syst...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-13
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  -     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Medical Physics, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Genotyping of skin and soft tissue infection (SSTI)-associated methicillin-resistant Staphylococcus ...
Next Document:  Hemophilic Chronic Synovitis: Therapy of Hemarthrosis using Endovascular Embolization of Knee and El...