title: Long-term efficacy of a mini-course in radiation-reducing techniques in invasive cardiology.
abstract: OBJECTIVE
  To validate the long-term efficacy of a 90-min. educational mini-course in less-irradiating cardiac interventional techniques.
  
  
  METHODS
  Before, two months after, and two years after the mini-course (periods I, II, and III), we analyzed the following radiation dose parameters for ten coronary angiographies (CA), performed by each of 7 cardiologists: total dose-area product (DAP), radiographic and fluoroscopic DAP fractions, number of radiographic frames and runs, and fluoroscopy time.
  
  
  RESULTS
  The median patient DAP for periods I, II and III was 31.4, 15.8 and 8.5 Gy × cm2, respectively. The long-term effect was related to shorter median fluoroscopy times (180, 172, and 120 s), shorter (57, 52, and 45) and fewer (12, 12, and 10) radiographic runs, consistent collimation and restriction to an adequate image quality. Both radiographic DAP/frame (28.7, 17.0, and 18.4 mGy × cm2) and fluoroscopic DAP/second (45.7, 24.2, and 10.0 mGy × cm2) decreased significantly. The multivariate linear regression analysis confirmed the increasing efficacy of the mini-course itself (-44.6 and -60.7%), and revealed a decreasing influence of the interventionalist's experience (-8.6% and -4.9% per 1,000 CAs, lifelong performed until the mini-course). The number of CAs performed after the mini-course did not influence the long-term DAP results.
  
  
  CONCLUSIONS
  The presented educational mini-course allows a significant, long-lasting, and apparently ongoing reduction of patient radiation exposure due to CA. A self-surveillant documentation of relevant radiation parameters is well suited to monitor and improve each operator's individual long-term radiation-reducing efforts.
authors.affiliation: Abteilung für Kardiologie, Klinik Fränkische Schweiz, Ebermannstadt, Germany. eberhard.kuon@gmx.de
authors.forename: E
authors.initials: E
authors.lastname: Kuon
authors.forename: K
authors.initials: K
authors.lastname: Empen
authors.forename: K
authors.initials: K
authors.lastname: Weitmann
authors.forename: A
authors.initials: A
authors.lastname: Staudt
authors.forename: A
authors.initials: A
authors.lastname: Hummel
authors.forename: M
authors.initials: M
authors.lastname: Dörr
authors.forename: T
authors.initials: T
authors.lastname: Reffelmann
authors.forename: W
authors.initials: W
authors.lastname: Hoffmann
authors.forename: S B
authors.initials: SB
authors.lastname: Felix
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000193:education* / Q000379:methods; D002309:Cardiology / Q000193:education*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods*; D003479:Curriculum; D004502:Education, Medical, Continuing; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects* / Q000379:methods*; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000517:prevention & control*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011874:Radiometry / Q000379:methods; D012542:Scattering, Radiation