Radiation exposure to patients and operators during diagnostic catheterization and coronary angioplasty

A detailed monitoring, on the basis of single procedures, was undertaken to assess the patient exposure and the occupational doses received by the operators (cardiologist, technician, and nurse) during diagnostic coronary angiography (CAG) and percutaneous transluminal coronary angioplasty (PTCA). The occupational dose to the staff was measured at the collar level using thermoluminescent dosimeters (TLD) to examine the neck and head exposure. Patient exposure was assessed by the dose-area product (DAP in Gy/cm2) and by the skin dose (mGy) at the level of thyroid. The mean neck dose per procedure for cardiologist was about 0.05 mGy, a reasonable level to comply with the International Commission on Radiological Protection (ICRP) eye lens recommended limit. No significant differences were detected between CAG (39 procedures) and PTCA (19 procedures). Relatively high radiation doses are given to the lung of the patient with a significant ICRP lifetime risk of about 10(-3). The patients' mean DAP was 55.9 Gy/cm2 for CAG (79 procedures) and 91.8 Gy/cm2 for PTCA (31 procedures) (P < 0.01). About 70% in CAG and 48% in PTCA of the total dose resulted from the cine examination; in PTCA the total mean DAP was about 60% higher than in CAG procedures.