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首页> 外文期刊>The American Journal of Cardiology >Assessment of Local Dose Reference Values for Recanalization of Chronic Total Occlusions and Other Occlusions in a High-Volume Catheterization Center
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Assessment of Local Dose Reference Values for Recanalization of Chronic Total Occlusions and Other Occlusions in a High-Volume Catheterization Center

机译：大剂量导尿中心对慢性总闭塞和其他闭塞再通的局部剂量参考值的评估

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摘要

The increasing number and complexity of these procedures have led to a higher number of patients at risk for tissue reactions like skin injuries. Monitoring of their dose indicators is essential in recognizing these patients. The aim of this work was to determine local diagnostic reference levels (DRLs) for recanalization of chronic total occlusion (CTO) and other occlusions procedures. All data from patients who underwent cardiac procedures were reviewed and classified according to their complexity. Dose indicators such as fluoroscopy time (FT), dose area product (DAP), and air kerma at patient entrance reference point (AK(r)) were recorded. Correlations with patient's body mass index, operators, procedure strategy, and complexity were studied. For CTO, the mean DAP, AK(r) and FT were 252 +/- 234 Gycm(2), 3,985 +/- 3,579 mGy, and 47 +/- 36 minutes, respectively. To better reflect the non-Gaussian distribution of data, the median and the 75th percentile values were also reported: median DAP, 172 Gycm(2); 75th percentile DAP, 350 Gycm(2); median AK(r) 2,714 mGy; and 75th percentile AK(r), 5,921 mGy. A tentative new set of values were suggested to take into account the complexity difference in recanalization of total occlusions according to their antegrade or retrograde approach. These approach-specific DRLs for total occlusions were mean DAP (120 114 Gycm2), mean AK(r) (1,789 +/- 1,933 mGy), and mean FT (22 +/- 18 minutes) for antegrade approach and mean DAP (459 +/- 304 Gycm(2)), mean AK(r) (6,881 +/- 4,243 mGy), and mean FT (82 +/- 40 minutes) for retrograde approach. The other significant values were median DAP (84 Gycm2), 75th percentile PAP (147 Gycm2), median AK(r) (1,160 mGy), and 75th percentile AK, (2,176 mGy) for antegrade approach and median DAP (422 Gycm(2)), 75th percentile DAP (552 Gycm(2)), median AK(r) (6,295 mGy), and 75th percentile AK(r) (8,064 mGy) for retrograde approach. In conclusion, a set of local DRL values from a large center were assessed. DRLs were provided for antegrade and retrograde approaches, reflecting the difference in difficulty from these 2 kinds of CTOs. The wide dose estimator values variations were explained through procedure complexity. The values obtained for the other more classic percutaneous coronary interventions were comparable with those found in the literature. (C) 2015 Elsevier Inc. All rights reserved.
机译：这些程序的数量和复杂性不断增加，导致更多的患者有发生皮肤损伤等组织反应的风险。监测其剂量指标对于识别这些患者至关重要。这项工作的目的是确定局部诊断参考水平（DRL），以重新进行慢性完全阻塞（CTO）和其他阻塞程序。回顾了接受心脏手术的患者的所有数据，并根据其复杂性对其进行了分类。记录剂量指标，例如荧光检查时间（FT），剂量面积乘积（DAP）和患者进入参考点（AK（r））的空气比释动能。研究了患者体重指数，操作者，手术策略和复杂性之间的关系。对于CTO，平均DAP，AK（r）和FT分别为252 +/- 234 Gycm（2），3,985 +/- 3,579 mGy和47 +/- 36分钟。为了更好地反映数据的非高斯分布，还报告了中位数和第75个百分位数：DAP中位数为172 Gycm（2）; 75％的DAP，350 Gycm（2）;中值AK（r）2,714 mGy;和第75个百分数AK（r），5,921 mGy。建议使用一组新的暂定值，以根据其顺行或逆行方法将总闭塞再通的复杂性考虑在内。这些针对总闭塞的方法特定的DRLs是平均DAP（120114 Gycm2），平均AK（r）（1,789 +/- 1,933 mGy）和平均FT（22 +/- 18分钟）用于顺行进路和平均DAP（459 +/- 304 Gycm（2）），平均AK（r）（6,881 +/- 4,243 mGy）和平均FT（82 +/- 40分钟）。其他显着值包括正中进路的DAP中位数（84 Gycm2），PAP的第75个百分位数（147 Gycm2），AK（r）的中位数（1,160 mGy）和正行进路的中位数DAP（422 Gycm（2）为2176 mGy） ）），75％的DAP（552 Gycm（2）），中位数AK（r）（6,295 mGy）和75％的AK（r）（8,064 mGy）用于逆行法。总之，评估了一个大型中心的一组本地DRL值。为顺行和逆行提供了DRL，反映了这两种CTO在难度上的差异。宽剂量估计值的变化通过程序复杂性进行了解释。其他更经典的经皮冠状动脉介入治疗获得的值与文献中发现的值相当。 （C）2015 Elsevier Inc.保留所有权利。

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