title: Indicators of the maximum radiation dose to the skin during percutaneous coronary intervention in different target vessels.
abstract: OBJECTIVE
  To evaluate whether the maximum radiation dose to the patient's skin (MSD) can be estimated during percutaneous coronary intervention (PCI) procedures, we investigated the relationship between the MSD and fluoroscopic time, dose-area product (DAP), and body weight, separately analyzing the relationships for different target vessels.
  
  
  BACKGROUND
  Many cases of skin injury caused by excessive radiation exposure during cardiac intervention procedures have been reported. However, real-time maximum-dose monitoring of the skin is unavailable for many cardiac intervention procedures.
  
  
  METHODS
  We studied 197 consecutive PCI procedures that involved a single target vessel and were conducted. The DAP was measured, and the MSD was calculated by a skin-dose mapping software program (Caregraph). The target vessels of the PCI procedures were divided into four groups based on the AHA classification system: AHA 5-10, left anterior descending artery domain (LAD), AHA 11-15, left circumflex artery domain (LCx), AHA 1-3 = R 1-3, and AHA 4 = R 4.
  
  
  RESULTS
  The correlation coefficient (r) between the MSD and fluoroscopic time was higher for the right coronary artery (RCA) vessels (R 1-3, 0.852; R 4, 0.715) than for the left coronary artery (LCA) vessels (LAD, 0.527; LCx, 0.646), and the r value between the MSD and DAP was higher for the RCA vessels (R 1-3, 0.871; R 4, 0.898) than for the LCA vessels (LAD, 0.628; LCx, 0.694). Similarly, the correlation coefficient between the MSD and weight x fluoroscopic time (WFP) was higher for the RCA vessels (R 1-3, 0.874; R 4, 0.807) than for the LCA vessels (LAD, 0.551; LCx, 0.735).
  
  
  CONCLUSIONS
  The DAP and WFP can be used to estimate the MSD during PCI in the RCA but not in the LCA, especially the LAD.
authors.affiliation: Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, Sendai, Japan. chida@mail.tains.tohoku.ac.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Chida
authors.forename: Haruo
authors.initials: H
authors.lastname: Saito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kagaya
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kohzuki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takai
authors.forename: Shoki
authors.initials: S
authors.lastname: Takahashi
authors.forename: Shogo
authors.initials: S
authors.lastname: Yamada
authors.forename: Masayuki
authors.initials: M
authors.lastname: Zuguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001835:Body Weight; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012867:Skin / Q000528:radiation effects*; D013997:Time Factors