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La influencia del equipo radiográfico, la configuración y la experiencia del operador en la exposición a la radiación
Gerald S Werner1, Alexandre Avran2, Nicolas Boudou3
1University Heart & Vascular Centre, Frankfurt, Germany.
Resumen
La exposición a la radiación durante las recanalizaciones de oclusión total crónica (CTO) disminuyó significativamente en nueve años debido a las actualizaciones del equipo. Sin embargo, las diferencias en la experiencia del operador y las técnicas de colimación siguen teniendo un impacto en la administración de la dosis de radiación.
Área de la Ciencia:
- Cardiología intervencionista
- Imágenes médicas
- Seguridad contra las radiaciones
Sus antecedentes:
- Los procedimientos de recanalización para las oclusiones coronarias totales crónicas (OTC) conllevan un riesgo significativo de exposición a la radiación.
- La optimización de la seguridad radiológica es crucial para el bienestar del paciente y del operador durante estas complejas intervenciones.
Objetivo del estudio:
- Investigar el impacto del equipo radiográfico, los protocolos de radiación y la experiencia del operador en la exposición a la radiación durante las recanalizaciones de CTO.
- Identificar los factores que contribuyen a la variabilidad entre los operadores en la gestión de la dosis de radiación.
Principales métodos:
- Análisis de 17.769 procedimientos CTO de un registro europeo multicéntrico (2015-2023).
- Categoría de los operadores en experimentados (generación 1, > 10 años) y recientes (generación 2).
- Evaluación de las métricas de radiación, incluidos el Air Kerma (AK), el Producto de Área de Dosificación (DAP), el Índice de Tasa de Dosificación (DRI) y el Índice de Collimación (CLI).
Principales resultados:
- A pesar del aumento de la complejidad de la lesión, la exposición total a la radiación (AK y DAP) disminuyó en un 45%.
- Las actualizaciones del equipo desempeñaron un papel clave en la reducción de la dosis de radiación.
- La variabilidad entre operadores en el índice de velocidad de dosis mejoró, pero las prácticas de colimación no mostraron cambios significativos.
Conclusiones:
- La exposición a la radiación en las instalaciones CTO PCI se ha reducido con éxito durante un período de 9 años tanto para los operadores experimentados como para los recientes.
- Los avances tecnológicos en los equipos radiográficos son vitales para una gestión eficaz de la radiación.
- Las diferencias persistentes entre los operadores en el manejo de la dosis y la colimación resaltan las áreas de mejora adicional.
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