Effectiveness of the implementation of a simple radiation reduction protocol in the catheterization laboratory.
BACKGROUND AND PURPOSE
A reduction in radiation doses at the catheterization laboratory, maintaining the quality of procedures is essential. Our objective was to analyze the results of a simple radiation reduction protocol at a high-volume interventional cardiology unit.


METHODS
We analyzed 1160 consecutive procedures: 580 performed before the implementation of the protocol and 580 after it. The protocol consisted in: the reduction of the number of ventriculographies and aortographies, the optimization of the collimation and the geometry of the X ray tube-patient-receptor, the use of low dose-rate fluoroscopy and the reduction of the number of cine sequences using the software "last fluoroscopy hold".


RESULTS
There were no significant differences in clinical baseline features or in the procedural characteristics with the exception of a higher percentage of radial approach (30.7% vs 69.6%; p<0.001) and of percutaneous coronary interventions of chronic total occlusions after the implementation of the protocol (2.1% vs 6.7%; p=0,001). Angiographic success was similar during both periods (98.3% vs 99.2%; p=0.2). There were no significant differences between both periods regarding the overall duration of the procedures (26.9 vs 29.6min; p=0.14), or the fluoroscopy time (13.3 vs 13.2min; p=0.8). We observed a reduction in the percentage of procedures with ventriculography (80.9% vs 7.1%; p<0.0001) or aortography (15.4% vs 4.4%; p<0.0001), the cine runs (21.8 vs 6.9; p<0.0001) and the dose-area product (165 vs 71 Gyxcm(2); p<0.0001).


CONCLUSIONS
With the implementation of a simple radiation reduction protocol, a 57% reduction of dose-area product was observed without a reduction in the quality or the complexity of procedures.
['Jurado-Román|Alfonso|A|', 'Sánchez-Pérez|Ignacio|I|', 'Lozano Ruíz-Poveda|Fernando|F|', 'López-Lluva|María T|MT|', 'Pinilla-Echeverri|Natalia|N|', 'Moreno Arciniegas|Andrea|A|', 'Agudo-Quilez|Pilar|P|', 'Gil Agudo|Antonio|A|']
D000368:Aged D000369:Aged, 80 and over D001027:Aortography D006328:Cardiac Catheterization D002932:Cineangiography D017023:Coronary Angiography D005260:Female D005471:Fluoroscopy D006331:Heart Diseases D061847:Hospitals, High-Volume D006801:Humans D008297:Male D008875:Middle Aged D016273:Occupational Exposure D016272:Occupational Health D009873:Operating Rooms D061214:Patient Safety D062645:Percutaneous Coronary Intervention D011237:Predictive Value of Tests D015397:Program Evaluation D011446:Prospective Studies D011829:Radiation Dosage D000069079:Radiation Exposure D011857:Radiographic Image Interpretation, Computer-Assisted D015641:Radiography, Interventional D015635:Radionuclide Ventriculography D012984:Software D013997:Time Factors
Radiation Interventional cardiology Last fluoroscopy hold