期刊论文详细信息
Frontiers in Cardiovascular Medicine
Radiation Exposure Reduction and Patient Outcome by Using Very Low Frame Rate Fluoroscopy Protocol (3.8 + 7.5 fps) During Percutaneous Coronary Intervention
article
Ankush Gupta1  Sanya Chhikara2  Rajesh Vijayvergiya3  Parag Barwad3  Krishna Prasad3  Rajat Datta4  Nalin K. Mahesh5  Preetika Maurya6  Navreet Singh7 
[1] Department of Cardiology, Military Hospital Jaipur;Vardhman Mahavir Medical College, & Safdarjung Hospital;Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research Chandigarh;Department of Cardiology, Army Hospital Research & Referral;Department of Cardiology, Apollo Adlux Hospital;Base Hospital Delhi Cantt;Department of Cardiology, The Air Force Central Medical Establishment
关键词: percutaneous coronary intervention;    fluoroscopy;    air kerma;    radiation;    frame rate;    cine acquisition;   
DOI  :  10.3389/fcvm.2021.625873
学科分类:地球科学(综合)
来源: Frontiers
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【 摘 要 】

Objectives: In this study, we intend to analyze the feasibility and efficacy of very low frame rate fluoroscopy (VLFF) protocol using a combination of 3.8 and 7.5 fps while performing Percutaneous Coronary Intervention (PCI). Methods: A retrospective cohort including 193 patients undergoing PCI under the VLFF protocol (Post-VLFF group) was compared with a retrospective cohort of 133 patients, who underwent PCI prior to implementation of VLFF protocol (Pre-VLFF group). In the Pre-VLFF group, all PCIs were performed using fluoroscopy frame rate of 15 fps. In the Post-VLFF group, 3.8 fps was used to guide catheter engagement, coronary lesion wiring, pre-and post-dilation, and 7.5 fps was used for lesion assessment and stent placement. Increasing use of fluoroscopic storage in place of cineangiography was also encouraged. Cine acquisition in both groups was performed at 15 fps. Primary endpoint was radiation exposure measured by Air Kerma. Secondary endpoints were procedure related outcomes and patient related outcomes (Major Adverse Cardiac Events including all-cause mortality, Target Lesion Failure, Myocardial Infarction, and Stroke). RESULTS: Post-VLFF group showed 74.7% reduction in Air Kerma as compared to Pre-VLFF group (433 ± 27 mGy vs. 1,714 ± 140 mGy; p < 0.0001), with no increase in the fluoroscopy time (15.38 ± 0.98 min Post-VLFF vs. 17.06 ± 1.29 min Pre-VLFF; p = 0.529) and contrast volume (116.5 ± 4.9 ml Post-VLFF vs. 116.7 ± 6 ml Pre-VLFF; p = 0.700). Both groups had comparable procedural success and complications rates as well as incidence of MACE. Conclusions: The very low frame rate fluoroscopy protocol is a feasible, effective, and safe method to significantly reduce the radiation exposure during PCI without any compromise on procedural and patient outcomes.

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