Evaluation of peak skin dose during percutaneous coronary intervention procedures: relationship with fluoroscopic...

This study aimed to evaluate the relationship between the peak skin dose (PSD) associated with radiation skin injury and the fluoroscopic pulse rate or target vessel during percutaneous coronary intervention (PCI) procedures. We consecutively included 213 patients who underwent PCI procedures. The fluoroscopic time (FT), total number of cine frames, reference air kerma (RAK), and PSD were compared between the two types of fluoroscopic pulse rates (10 and 7.5 pulses/s) and among target vessels. The total number of X-ray tube angulations for each target vessel was also investigated. The median FT was 21.5 min in the 10 pulses/s group and 19.4 min in the 7.5 pulses/s group (p = 0.068, Wilcoxon rank sum test). The median PSD in the 10 pulses/s group was 749 mGy, which was significantly higher than that in the 7.5 pulses/s group (549 mGy) (p < 0.001). The median RAK in the right coronary artery (RCA) was equivalent to that in the left anterior descending artery. However, among the target vessels, the median PSD tended to be the highest in the RCA. There was a difference in the X-ray tube angulation used depending on the target vessel. PCI in the RCA used the left anterior oblique angle more frequently than PCI in the other vessels and tended to use only one angulation. The calculated PSD was related to the target vessel of the PCI procedure, and it was also closely related to the X-ray tube angulation.