- Email: [email protected]
TCT-853 Use of a Novel Lead-based Arm-Board to Reduce Radiation Exposure to Operators During Invasive Cardiac Procedures
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 18, SUPPL B, 2016
TCT-853 Use of a Novel Lead-based Arm-Board to Reduce Radiation Exposure to Operators During Invasive Cardiac Procedures Michael Mack,1 Usha Manian,2 Mariana Dieste,3 Andrew McLellan,4 Pallav Garg5 1 The Heart Hospital Baylor Plano, London, Ontario, Canada; 21st Dpt of Cardiology, Medical School, UOA; 3Centro Cardiológico Americano; 4 ICBA; 5Hospital Central “Dr. Ignacio Morones Prieto” BACKGROUND Cardiac catheterization is associated with significant radiation exposure to the operator. Radiation safety employing the As Low As Reasonably Achievable (ALARA) principle includes use of lead shielding to reduce operator exposure. Furthermore, radial approach is now preferred and may be associated with more radiation exposure compared with femoral approach. We sought to evaluate whether use of a novel lead-based arm-board will result in lower radiation exposure to the operator versus usual practice.
B345
RESULTS The CV diseases (32,552,622 CV pts, or 22.2% of the population, 2012) in Russia accounted for 54.9% of all deaths. The death rate in 2012 was 13.3 per 1,000 citizens with CV mortality of 653.9 per 100,000 in 2014 (see figure). The mean age of pts in the trial was 51.6 yr (77.2% males). 175 Russian PCI centers in 2012 implemented 205,902 angio, and 75,378 PCI (69.8% of MI, and 31.2% of angina) achieving 531 PCI per 1,000,000 population with placement of 101,451 stents (1.37 stents per PCI; 48,057 DES). 45 PCI centers were ready for IVUS (1,632; 1.8% of all PCI), OCT (773; 0.9% cases) and FFR (410; 0.5%). Russia experienced truly dramatic 16-time enhancement of the angio affordability from 107 in 2000 up to 1,715 in 2013. Exactly 90,335 coronary PCI interventions (636.6 coronary PCI with 1.37 implanted stents per one patient; transradial access – 36.9%) were implemented in 185 PCI centers (1.30 PCI centers) in 2013 with a 19.8% annual growth and a 24-time 13-year increase from 27 coronary interventions in 2000 to 636 in 2013 which is significantly lower than in Europe (average 1,871 in 2013).
METHODS In this proof-of-concept pilot study we evaluated radiation exposure to the primary operator in 72 patients undergoing cardiac catheterization and/or percutaneous coronary intervention (PCI) with or without the lead-based arm-board. Radiation was measured using a personal dosimeter at the level of the chest and left arm. The primary outcome was the radiation dose to operator at the chest and arm level, external to worn lead. Secondary outcomes included radiation dose to the patient, number of cine acquisitions and total fluoroscopy time. RESULTS We analyzed radiation data to operator and patient during 72 procedures (37 investigation; 35 control). The mean age of patients was 64 and most were male (75%). The majority of procedures were by radial approach (82%) and 40% had PCI. There were no significant differences in measured baseline or procedural characteristics between the two groups. The lead-based arm-board significantly reduced the radiation dose to operator at the chest level (1.1 vs. 2.1 mrem, p¼0.0015) with a trend towards reduction at the arm level (2.6 vs. 4.7 mrem, p¼0.06). There was no significant difference in the patient dose (8841 vs. 6762, p¼0.14). CONCLUSION In this pilot study, radiation dose to primary operator was significantly reduced with a lead-based arm-board. A larger, randomized trial is underway to evaluate this further. CATEGORIES IMAGING: Cath Lab of the Future TCT-854 Cardiovascular Burden and Percutaneous Interventions in Russia: Epidemiological Update and Results of National Screening Alexander Kharlamov1 1 De Haar Research Foundation, Rotterdam, Netherlands BACKGROUND The purpose was to explore cardiovascular (CV) burden in Russia outlined by high CV mortality and shorter lifespan with a focus on affordablity of the percutaneous interventions. METHODS We overviewed data sources of 2001-2014 from Bokeria’s Cardiac Center, Russian authorities, RIA news, and NANOM-FIM trial (NCT01270139).
CONCLUSION Mortality statistics show the stark reality of a high CV burden in Russia which requires emerging efforts to tackle CV diseases. CATEGORIES OTHER: Public Health Issues
TCT-853 Use of a Novel Lead-based Arm-Board to Reduce Radiation Exposure to Operators During Invasive Cardiac Procedures Michael Mack,1 Usha Manian,2 Mariana Dieste,3 Andrew McLellan,4 Pallav Garg5 1 The Heart Hospital Baylor Plano, London, Ontario, Canada; 21st Dpt of Cardiology, Medical School, UOA; 3Centro Cardiológico Americano; 4 ICBA; 5Hospital Central “Dr. Ignacio Morones Prieto” BACKGROUND Cardiac catheterization is associated with significant radiation exposure to the operator. Radiation safety employing the As Low As Reasonably Achievable (ALARA) principle includes use of lead shielding to reduce operator exposure. Furthermore, radial approach is now preferred and may be associated with more radiation exposure compared with femoral approach. We sought to evaluate whether use of a novel lead-based arm-board will result in lower radiation exposure to the operator versus usual practice.
B345
RESULTS The CV diseases (32,552,622 CV pts, or 22.2% of the population, 2012) in Russia accounted for 54.9% of all deaths. The death rate in 2012 was 13.3 per 1,000 citizens with CV mortality of 653.9 per 100,000 in 2014 (see figure). The mean age of pts in the trial was 51.6 yr (77.2% males). 175 Russian PCI centers in 2012 implemented 205,902 angio, and 75,378 PCI (69.8% of MI, and 31.2% of angina) achieving 531 PCI per 1,000,000 population with placement of 101,451 stents (1.37 stents per PCI; 48,057 DES). 45 PCI centers were ready for IVUS (1,632; 1.8% of all PCI), OCT (773; 0.9% cases) and FFR (410; 0.5%). Russia experienced truly dramatic 16-time enhancement of the angio affordability from 107 in 2000 up to 1,715 in 2013. Exactly 90,335 coronary PCI interventions (636.6 coronary PCI with 1.37 implanted stents per one patient; transradial access – 36.9%) were implemented in 185 PCI centers (1.30 PCI centers) in 2013 with a 19.8% annual growth and a 24-time 13-year increase from 27 coronary interventions in 2000 to 636 in 2013 which is significantly lower than in Europe (average 1,871 in 2013).
METHODS In this proof-of-concept pilot study we evaluated radiation exposure to the primary operator in 72 patients undergoing cardiac catheterization and/or percutaneous coronary intervention (PCI) with or without the lead-based arm-board. Radiation was measured using a personal dosimeter at the level of the chest and left arm. The primary outcome was the radiation dose to operator at the chest and arm level, external to worn lead. Secondary outcomes included radiation dose to the patient, number of cine acquisitions and total fluoroscopy time. RESULTS We analyzed radiation data to operator and patient during 72 procedures (37 investigation; 35 control). The mean age of patients was 64 and most were male (75%). The majority of procedures were by radial approach (82%) and 40% had PCI. There were no significant differences in measured baseline or procedural characteristics between the two groups. The lead-based arm-board significantly reduced the radiation dose to operator at the chest level (1.1 vs. 2.1 mrem, p¼0.0015) with a trend towards reduction at the arm level (2.6 vs. 4.7 mrem, p¼0.06). There was no significant difference in the patient dose (8841 vs. 6762, p¼0.14). CONCLUSION In this pilot study, radiation dose to primary operator was significantly reduced with a lead-based arm-board. A larger, randomized trial is underway to evaluate this further. CATEGORIES IMAGING: Cath Lab of the Future TCT-854 Cardiovascular Burden and Percutaneous Interventions in Russia: Epidemiological Update and Results of National Screening Alexander Kharlamov1 1 De Haar Research Foundation, Rotterdam, Netherlands BACKGROUND The purpose was to explore cardiovascular (CV) burden in Russia outlined by high CV mortality and shorter lifespan with a focus on affordablity of the percutaneous interventions. METHODS We overviewed data sources of 2001-2014 from Bokeria’s Cardiac Center, Russian authorities, RIA news, and NANOM-FIM trial (NCT01270139).
CONCLUSION Mortality statistics show the stark reality of a high CV burden in Russia which requires emerging efforts to tackle CV diseases. CATEGORIES OTHER: Public Health Issues