title: Reversed C-arm projection for reduction of focal skin radiation exposure: experimental analysis and first clinical experience.
abstract: Radiodermatitis, predominantly over the right scapula, is a well-known complication of complex percutaneous coronary interventions (PCI). To reduce focal radiation exposure, we analyzed an inversed X-ray beam direction using a reversed C-arm position. On phantom experiment, we found that 130° right anterior oblique projection reduced skin dose over the right scapula by 98.2 % (P < 0.001) compared with conventional 50° left anterior oblique projection. A 73-year-old man with history of bypass surgery, multiple PCI and chronic radiodermatitis over the right scapula presented with recurrent chest pain. After successful PCI using the reversed C-arm projection, no aggravation of radiodermatitis was found.
authors.affiliation: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, 2-2 Yamada Oka, Suita, Osaka, 565-0871, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Yokoi
authors.forename: Satoru
authors.initials: S
authors.lastname: Sumitsuji
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneda
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Siegrist
authors.forename: Koichi
authors.initials: K
authors.lastname: Tachibana
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D056888:Patient Positioning; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D011829:Radiation Dosage; D011855:Radiodermatitis / Q000517:prevention & control*; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods; D012008:Recurrence; D012307:Risk Factors