title: Patient exposure to X-rays during coronary angiography and percutaneous transluminal coronary intervention: results of a multicenter national survey.
abstract: OBJECTIVE
  To evaluate practices for the protection from radiation of patients during coronary angiography (CA) and percutaneous coronary intervention (PCI), and to update reference values for the main radiation dose parameters.
  
  
  BACKGROUND
  Few multicenter data from large populations exist on radiation doses to patients during CA and PCI.
  
  
  METHODS
  RAY'ACT is a multicenter, nationwide French survey, with retrospective analysis of radiation parameters routinely registered in professional software from 33,937 CAs and 27,826 PCIs performed at 44 centers from January 1, through December 31, 2010.
  
  
  RESULTS
  Kerma-area product (KAP) was registered in 91.7% (44/48) of centers and in 91.5% of procedures for CA (median, 27.2 Gy·cm(2) , interquartile range [IQR], 15.5-45.2) and 91.1% for PCI (median, 56.8 Gy·cm(2) , IQR, 32.8-94.6). Fluoroscopy time was registered in 87.5% (42/48) of centers and in 83.1% of procedures (median, 3.7 min, IQR, 2.3-6.3 for CA; 10.3 min, 6.7-16.2 for PCI). Variability across centers was high. Old equipment and routine left ventriculography were more common and number of registered frames and frame rate were higher in centers delivering high doses. The radial route was associated with lower doses than the femoral route (median KAP 26.8 Gy·cm(2) [15.1-44.25] vs. 28.1 [16.4-46.9] for CA, respectively; and 55.6 Gy·cm(2) [32.2-92.1] vs. 59.4 [24.6-99.9] for PCI, respectively; P < 0.01).
  
  
  CONCLUSIONS
  This survey showed a very high rate of compliance with dose registration during CA and PCI in French nonacademic hospitals. Updated diagnostic reference values are established for the main dose parameters (KAP, 45 Gy·cm(2) for CA, 95 Gy·cm(2) for PCI).
authors: Service de Cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France; College National des Cardiologues des Hopitaux, Paris, France.
authors: Jean-Louis
authors: JL
authors: Georges
authors: Loic
authors: L
authors: Belle
authors: Cécile
authors: C
authors: Ricard
authors: Simon
authors: S
authors: Cattan
authors: Franck
authors: F
authors: Albert
authors: Jean-Lou
authors: JL
authors: Hirsch
authors: Jacques
authors: J
authors: Monsegu
authors: Alain
authors: A
authors: Dibie
authors: Khalife
authors: K
authors: Khalife
authors: Christophe
authors: C
authors: Caussin
authors: Carlo
authors: C
authors: Maccia
authors: Bernard
authors: B
authors: Livarek
authors: Michel
authors: M
authors: Hanssen
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000009:adverse effects / Q000592:standards; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005471:Fluoroscopy; D005602:France; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000592:standards; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D017534:Radial Artery / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D015641:Radiography, Interventional / Q000009:adverse effects / Q000592:standards; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: coronary angiography; diagnostic reference levels; dose area product; patient radiation protection; percutaneous coronary intervention