Journal of the Society for Cardiovascular Angiography & Interventions最新文献

英文中文

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102435

Jun Li MD , Dmitriy N. Feldman MD , Andrew J. Klein MD , Mahmoud B. Malas MD, MHS, RPVI , D. Christopher Metzger MD , Sahil A. Parikh MD , Gary S. Roubin MD, PhD , Peter A. Soukas MD , Shirling Tsai MD , William A. Gray MD , Members of the SCAI 2024 Think Tank Peripheral Consortium, Cody Bliss PhD , Kevin Brounstein , Fely Canorea-Vega MD , Richard Dean , Gina Donnelly , Lindsay Farrel , Shane Gleason , Chris Hughes , Michael Kohler , Jennifer Williams

引用次数: 0

Can Contrast Injections Cause or Propagate Coronary Injuries? Insights From Vessel and Guiding Catheter Hemodynamics 注射造影剂会导致或加剧冠状动脉损伤吗？从血管和导管血流动力学的见解。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102396

Daniel Chamié MD, PhD , Rahul Bahl MBBS , Julio Maia MD , Mauro Echavarria-Pinto MD , Suraya Gafore MBBS , Amr Saleh MD , Ecaterina Cristea MD , Henry Seligman MBBS , Rodrigo M. Joaquim MD , Fausto Feres MD, PhD , Sayan Sen MD , Rasha Al-Lamee MBBS , Marinella Centemero MD, PhD , Christopher Baker MD, PhD , Tom Johnson MD , Matthew J. Shun-Shin BM, BCh, PhD , Alexandra J. Lansky MD , Ricardo Petraco MD, PhD

Background

The mechanistic association between the hydraulic forces generated during contrast injection and the risk of coronary injury is poorly understood. In this study, we sought to evaluate whether contrast injections increase intracoronary pressures beyond resting levels and estimate the risk of hydraulic propagation of coronary dissections.

Methods

This is a prospective, single-arm, multicenter study that included patients with nonculprit, non−flow-limiting coronaries. A continuous 60-second pressure recording was taken at 5 predetermined locations during contrast injections: distal, mid, and proximal vessel, catheter tip, and inside the catheter. The primary end point was the change in intracoronary peak pressure between resting and injections in each location.

Results

A total of 269 pressure recordings (58 vessels; 52 patients) were analyzed. Injections led to a small increase in peak pressure in the distal (mean difference, +4.5 mm Hg; 95% CI, 1.5-7.4), mid (mean difference, +4.1 mm Hg; 95% CI, 1.4-6.9), and proximal (mean difference, +5.1 mm Hg; 95% CI, 2.5-7.7) vessel locations, and much higher increases at the catheter tip (mean difference, +11.7 mm Hg; 95% CI, 5.8-17.7) and inside the catheter (mean difference, +77.5 mm Hg; 95% CI, 64.5-90.4). Compared to the distal vessel, pressure changes were only significant at the catheter tip (+10 mm Hg; P < .01) and inside the catheter (+79.1 mm Hg; P < .01).

Conclusions

Contrast injections lead to negligible changes in intracoronary pressures beyond the catheter tip. Although it is sensible to minimize injections when coronary dissections are close to the catheter, it is unlikely that they would cause injuries beyond the catheter tip.

背景：造影剂注射过程中产生的液压力与冠状动脉损伤风险之间的机制关系尚不清楚。在这项研究中，我们试图评估造影剂注射是否会使冠状动脉内压力超过静息水平，并评估冠状动脉剥离的水力传播风险。方法：这是一项前瞻性、单臂、多中心研究，纳入了非罪魁祸首、非血流限制性冠状动脉患者。在造影剂注射期间，在5个预定位置连续记录60秒的压力：远端、中端和近端血管、导管尖端和导管内部。主要终点是每个部位静息和注射之间冠状动脉内峰值压的变化。结果：共记录压力269次(血管58次；52例患者)进行分析。注射导致远端峰值压力小幅升高(平均差值+4.5 mm Hg；95% CI, 1.5-7.4)，中位(平均差，+4.1 mm Hg；95% CI, 1.4-6.9)和近端(平均差，+5.1 mm Hg；95% CI, 2.5-7.7)血管位置，导管尖端的增加要高得多(平均差异，+11.7 mm Hg；95% CI, 5.8-17.7)和导管内(平均差，+77.5 mm Hg；95% ci, 64.5-90.4)。与远端血管相比，压力变化仅在导管尖端显著(+10 mm Hg；P < 0.01)和导管内(+79.1 mm Hg；P < 0.01)。结论：造影剂注射导致导管尖端以外冠状动脉内压力的变化可以忽略不计。虽然当冠状动脉夹层靠近导管时尽量减少注射是明智的，但它们不太可能造成导管尖端以外的损伤。

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引用次数: 0

De Novo Atherosclerotic Renal Artery Stenosis Covered Stent Treatment for Resistant Hypertension (ARTISAN) Results 新动脉粥样硬化性肾动脉狭窄覆盖支架治疗顽固性高血压（ARTISAN）结果。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102400

Douglas E. Drachman MD , D. Christopher Metzger MD , Ashit Jain MD , Ravish Sachar MD , Amr El-Sayed Abbas MD , Kenneth Rosenfield MD , Gary M. Ansel MD

Background

Atherosclerotic renal artery stenosis (ARAS) may provoke hypertension and/or impaired kidney function. Some patients develop uncontrolled hypertension and deteriorating kidney function despite optimal medical therapy. In these patients, endovascular treatment is an important therapeutic option. ARTISAN was a prospective, open-label, single-arm, multicenter clinical trial to evaluate the safety and effectiveness of the iCast RX covered stent both functionally for reestablishing renal artery flow, and clinically for controlling resistant hypertension.

Methods

Patients considered for enrollment had average systolic blood pressure (SBP) ≥155 mm Hg despite taking 3 antihypertensive medications. Prior to enrollment and covered stent placement, angiographic confirmation of ARAS ≥80% with physiologic significance was required. Clinical assessments were performed at 30 days, 9 months, and annually through 36 months. Covered stent safety and efficacy were based on 9-month coprimary end points, including primary vessel patency and SBP improvement at 9 months. Secondary outcomes included target lesion revascularization, major adverse events, and secondary patency.

Results

Sixty-eight of the planned 138 subjects were enrolled. Primary patency was seen in 94.3% of subject lesions; the mean SBP reduction was 15.7 mm Hg. The functional and clinical end points met prespecified performance goals of 70% primary patency (P < .0001) and ≥10 mm Hg SBP decrease (P = .0192), respectively, at 9 months. Six subjects (8.8%) experienced 7 major adverse events within 36 months. The clinically driven target lesion revascularization rate was 7.3% at 36 months.

Conclusions

The high primary patency and improvement in SBP, persisting through 36 months, suggest that the iCast RX covered stent is safe and effective for the treatment of appropriately selected patients with ARAS.

背景：动脉粥样硬化性肾动脉狭窄（ARAS）可引起高血压和/或肾功能受损。一些患者发展不受控制的高血压和肾功能恶化，尽管最佳的药物治疗。在这些患者中，血管内治疗是一种重要的治疗选择。ARTISAN是一项前瞻性、开放标签、单臂、多中心临床试验，旨在评估iCast RX覆盖支架在功能上重建肾动脉血流和临床上控制顽固性高血压的安全性和有效性。方法：考虑入组的患者在服用3种降压药的情况下，平均收缩压(SBP)≥155 mm Hg。在入组和放置覆膜支架之前，需要血管造影确认ARAS≥80%并具有生理意义。临床评估分别在30天、9个月和每年进行，直至36个月。覆盖支架的安全性和有效性基于9个月的主要终点，包括9个月时的初级血管通畅和收缩压改善。次要结果包括靶病变血运重建、主要不良事件和继发性通畅。结果：计划138例受试者中有68例入组。94.3%的病灶原发通畅；平均收缩压降低15.7毫米汞柱。9个月时，功能和临床终点分别达到预定的70%原发性通畅（P < 0.0001）和≥10毫米汞柱收缩压降低（P = 0.0192）的性能目标。6名受试者（8.8%）在36个月内发生7次重大不良事件。36个月时临床驱动的靶病变血运重建率为7.3%。结论：高原发性通畅和持续36个月的收缩压改善表明iCast RX覆盖支架对于适当选择的ARAS患者是安全有效的。

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引用次数: 0

Efficacy of Zwolle Score in Predicting Outcomes of Patients With ST-Segment Elevation Myocardial Infarction Zwolle评分预测st段抬高型心肌梗死预后的疗效。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102389

Akshay Machanahalli Balakrishna MD , Khansa Ahmad MD , Melvin G. Joice MD , Alexander G. Truesdell MD , Syed Tanveer Rab MD , Jinnette Dawn Abbott MD , Saraschandra Vallabhajosyula MD, MSc

引用次数: 0

A Randomized Trial of Cardiac Catheterization With Fasting Versus Liberal Oral Intake: The CALORI Trial 一项空腹与自由口服心导管插入术的随机试验：CALORI试验。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102291

Brian K. Mitchell MD , Anna Tomdio MD , Muhammad S. Pir MD , Suraj K. Mishra MD , Pradeep Dayanand MD , Guillaume Bonnet MD, PhD , Maria C. Alu MS , Zachary M. Gertz MD

Background

Routine preprocedural fasting before cardiac catheterization remains common practice, despite a lack of robust evidence to support this practice. We investigated the impact of a liberal nonfasting strategy vs a standardized nil per os (NPO) regimen prior to cardiac catheterization.

Methods

Adult inpatients undergoing elective or urgent cardiac catheterization were randomized (1:1 ratio) to either NPO past midnight or ad libitum intake of liquids and solids (without dietary constraints) until immediately prior to the procedure. Only patients at high risk of aspiration or undergoing complex interventions were excluded. The primary end point was preprocedural patient-reported well-being scores (scaled 0-5, with 0 signifying absence of ailment and 5 the most extreme form), for variables including hunger, fatigue, anxiety, and nausea. A composite score summed the individual scores for hunger and fatigue. Other end points were periprocedural adverse events including emesis, aspiration, or intubation, in addition to postprocedural satisfaction.

Results

A total of 198 patients (65% male and 42% Black) were included in the final analysis. There were no differences in baseline characteristics between groups. Time from most recent oral intake (liquid or solid) to the start of the procedure averaged 148 minutes for the nonfasting group and 970 minutes for the NPO strategy (P < .001). The composite preprocedural well-being score was significantly better in the nonfasting arm (2.4 ± 2.4 nonfasting vs 6.0 ± 2.5 NPO; P < .001), as were the individual components of hunger (0.9 ± 1.5 vs 3.7 ± 1.5; P < .001), fatigue (1.5 ± 1.6 vs 2.3 ± 1.8; P < .001), and nausea (0.1 ± 0.5 vs 0.5 ±1.2; P = .006). There were no significant differences in adverse events between groups. Overall postprocedural satisfaction scores were significantly better in the nonfasting vs NPO group (0.3 ± 0.7 vs 1.0 ± 1.3, respectively; P < .001).

Conclusions

In this single-center randomized trial, a liberal nonfasting strategy prior to cardiac catheterization significantly improved patient well-being and satisfaction without compromising safety. Given the findings of this and other studies, routine fasting prior to cardiac catheterization should be reconsidered.

背景：尽管缺乏强有力的证据支持，心导管插入术前的常规术前禁食仍然是一种常见的做法。我们研究了在心导管插入术前自由非禁食策略与标准化零氧（NPO）方案的影响。方法：接受选择性或紧急心导管插入术的成年住院患者被随机（1:1比例）分为两组，一组在午夜过后进食，另一组在手术前随意进食液体和固体（没有饮食限制）。仅排除吸入风险高或正在接受复杂干预的患者。主要终点是手术前患者报告的幸福感评分（0-5分，0表示没有疾病，5表示最极端的形式），变量包括饥饿、疲劳、焦虑和恶心。一个综合分数综合了个人在饥饿和疲劳方面的得分。其他终点是围手术期不良事件，包括呕吐、误吸或插管，以及术后满意度。结果：198例患者（男性65%，黑人42%）纳入最终分析。两组间基线特征无差异。非禁食组从最近一次口服（液体或固体）到手术开始的平均时间为148分钟，NPO组为970分钟（P < 0.001）。非禁食组的综合手术前幸福感评分显著高于非禁食组（2.4±2.4 NPO vs 6.0±2.5 NPO）；P < 0.001)，饥饿的各个成分也是如此(0.9±1.5 vs 3.7±1.5；P < 0.001)，疲劳(1.5±1.6 vs 2.3±1.8；P < 0.001)，恶心(0.1±0.5 vs 0.5±1.2；P = .006)。两组间不良事件发生率无显著差异。非禁食组和NPO组的总体术后满意度得分显著高于对照组（分别为0.3±0.7和1.0±1.3）；P < 0.001)。结论：在这项单中心随机试验中，心导管插入术前的自由非禁食策略显著提高了患者的幸福感和满意度，同时不影响安全性。鉴于这项研究和其他研究的结果，应该重新考虑心导管插入术前的常规禁食。

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引用次数: 0

Three-Dimensional Rotational Angiography to Guide Cardiac Catheterization in Critical Infants Below 5kg of Body Weight 三维旋转血管造影指导5kg体重以下危重婴儿心导管插入术。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102391

Chenise N. Lucas MSc, Martijn G. Slieker PhD, Mirella M.C. Molenschot MD, Hans M.P.J. Breur PhD, Gregor J. Krings PhD

Background

Three-dimensional rotational angiography (3DRA) is a promising advancement to guide cardiac catheterizations. It is used with restraint in critically ill infants with congenital heart disease (CHD) due to the lack of research conducted within this patient group.

Methods

Data of all infants with CHD and a body weight <5 kg who underwent cardiac catheterization with the use of 3DRA between November 2011 and April 2021 were retrospectively analyzed. Primary outcome measures were 3DRA-related periprocedural deaths or major adverse events (MAEs). Secondary outcome measures were 3DRA-related minor adverse events (MiAEs), the amount of radiation exposure and contrast agent, and whether 3DRA led to important new findings. The case-based workflow of 3DRA in vulnerable infants is explained.

Results

Eighty-six patients underwent 109 cardiac catheterizations in which 132 3DRA scans were performed. Median age and weight were 50.0 days (IQR, 20.0-98.5) and 3.8 kg (IQR, 3.2-4.5). There were no periprocedural deaths or MiAEs, and only 2 MAEs occurred, both concerning ventricular fibrillation. The median radiation exposure was 160.0 cGy⋅cm² (IQR, 81.3-257.5), of which 28.0 cGy⋅cm² (IQR, 19.4-43.0) was derived from 3DRA. The mean amount of contrast agent used was 4.8 ± 1.6 mL/kg. In 70.6%, 3DRA imaging led to important new findings. Multivariate binary logistic regression analysis showed the presence of comorbidity to be associated with a lower odds of receiving a 3DRA-derived radiation dose ≥15 cGy⋅cm² (P = .01). Additionally, the interval between surgery and cardiac catheterization was significantly associated with higher odds of a contrast dye consumption ≥6 mL/kg (P = .046).

Conclusions

3DRA proved to be safe in vulnerable infants with CHD weighing <5 kg, enabling visualization of anatomical substrates often invisible in conventional angiography. However, when an advanced computed tomography scanner is available, the diagnostic purposes for 3DRA are few. The greatest benefit of 3DRA usage is interventional guidance (3D roadmap).

背景：三维旋转血管造影（3DRA）是一项有前途的进展，以指导心导管。由于缺乏对这一患者群体的研究，它在患有先天性心脏病（CHD）的危重婴儿中被限制使用。结果：86例患者进行了109次心导管手术，其中132次进行了3DRA扫描。中位年龄和体重分别为50.0日龄（IQR, 20.0 ~ 98.5）和3.8 kg （IQR, 3.2 ~ 4.5）。无围手术期死亡或心肌梗死，仅有2例心肌梗死发生，均与心室颤动有关。中位辐射暴露量为160.0 cGy⋅cm2 (IQR, 81.3 ~ 257.5)，其中来自3DRA的辐射暴露量为28.0 cGy⋅cm2 （IQR, 19.4 ~ 43.0）。造影剂平均用量为4.8±1.6 mL/kg。70.6%的3DRA成像有重要的新发现。多因素二元logistic回归分析显示，存在合并症与接受3dra衍生辐射剂量≥15 cGy⋅cm2的几率较低相关（P = 0.01）。此外，手术和心导管插入术之间的间隔与造影剂用量≥6 mL/kg的几率显著相关（P = 0.046）。结论：3DRA被证明是安全的易感婴儿冠心病称重

{"title":"Three-Dimensional Rotational Angiography to Guide Cardiac Catheterization in Critical Infants Below 5kg of Body Weight","authors":"Chenise N. Lucas MSc, Martijn G. Slieker PhD, Mirella M.C. Molenschot MD, Hans M.P.J. Breur PhD, Gregor J. Krings PhD","doi":"10.1016/j.jscai.2024.102391","DOIUrl":"10.1016/j.jscai.2024.102391","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional rotational angiography (3DRA) is a promising advancement to guide cardiac catheterizations. It is used with restraint in critically ill infants with congenital heart disease (CHD) due to the lack of research conducted within this patient group.</div></div><div><h3>Methods</h3><div>Data of all infants with CHD and a body weight <5 kg who underwent cardiac catheterization with the use of 3DRA between November 2011 and April 2021 were retrospectively analyzed. Primary outcome measures were 3DRA-related periprocedural deaths or major adverse events (MAEs). Secondary outcome measures were 3DRA-related minor adverse events (MiAEs), the amount of radiation exposure and contrast agent, and whether 3DRA led to important new findings. The case-based workflow of 3DRA in vulnerable infants is explained.</div></div><div><h3>Results</h3><div>Eighty-six patients underwent 109 cardiac catheterizations in which 132 3DRA scans were performed. Median age and weight were 50.0 days (IQR, 20.0-98.5) and 3.8 kg (IQR, 3.2-4.5). There were no periprocedural deaths or MiAEs, and only 2 MAEs occurred, both concerning ventricular fibrillation. The median radiation exposure was 160.0 cGy⋅cm<sup>2</sup> (IQR, 81.3-257.5), of which 28.0 cGy⋅cm<sup>2</sup> (IQR, 19.4-43.0) was derived from 3DRA. The mean amount of contrast agent used was 4.8 ± 1.6 mL/kg. In 70.6%, 3DRA imaging led to important new findings. Multivariate binary logistic regression analysis showed the presence of comorbidity to be associated with a lower odds of receiving a 3DRA-derived radiation dose ≥15 cGy⋅cm<sup>2</sup> (<em>P</em> = .01). Additionally, the interval between surgery and cardiac catheterization was significantly associated with higher odds of a contrast dye consumption ≥6 mL/kg (<em>P</em> = .046).</div></div><div><h3>Conclusions</h3><div>3DRA proved to be safe in vulnerable infants with CHD weighing <5 kg, enabling visualization of anatomical substrates often invisible in conventional angiography. However, when an advanced computed tomography scanner is available, the diagnostic purposes for 3DRA are few. The greatest benefit of 3DRA usage is interventional guidance (3D roadmap).</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102391"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous Mechanical Suction Use During Chronic Total Occlusion Revascularization 慢性全闭塞血运重建术中持续机械吸引的应用。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102392

Paul Gilbert MD , Taral Patel MD , Ankur Gupta MD

Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is high risk compared to non-CTO PCI. Iatrogenic coronary artery hematoma formation is a common occurrence during CTO PCI, impairing true lumen visualization. We describe the use of a continuous mechanical suction (CMS) device in 2 applications in which it was used for successful subintimal hematoma decompression and distal vessel re-entry. Additionally, we briefly review CMS utilization within the published literature. CMS use during CTO may be a viable technique in future revascularization attempts.

慢性全闭塞（CTO）经皮冠状动脉介入治疗（PCI）与非CTO的PCI相比是高风险的。医源性冠状动脉血肿形成在CTO PCI过程中很常见，损害了真正的管腔显像。我们描述了连续机械吸引（CMS）装置在2个应用中的使用，其中它被用于成功的内膜下血肿减压和远端血管再入。此外，我们简要回顾了CMS在已发表文献中的应用。在CTO期间使用CMS可能是未来血运重建尝试的可行技术。

引用次数: 0

Strategic Management of Valve Infolding in Evolut TAVR Procedures: Enhancing Outcomes and Ensuring Patient Safety Evolut TAVR手术中瓣膜夹闭的策略管理：提高疗效和确保患者安全。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102394

Rajendra Shah MBBS , Olayiwola Bolaji MD, MSc , Yasemin Bahar MD , Renu Sah MBBS , Anderson Chukwuka Ariaga MD , Timir K. Paul MD , Rajeev L. Narayan MD , M. Chadi Alraies MD

Transcatheter aortic valve repair (TAVR) presents a minimally invasive alternative to traditional surgical valve replacement, albeit not without its own set of complications. A rare complication is the infolding of the self-expanding valve, which can precipitate cardiac arrest. The estimated incidence rate of this complication stands at 1.6%. The management of this complication hinges on either balloon dilation or valve replacement. This article discusses a case involving a 78-year-old man with symptomatic severe aortic valve stenosis. Following TAVR, the patient experienced asystole due to valve infolding, highlighting the need for heightened vigilance and refined intervention strategies in the management of TAVR complications.

经导管主动脉瓣修复（TAVR）是传统手术瓣膜置换术的一种微创替代方法，尽管它本身也存在一些并发症。一种罕见的并发症是自扩张瓣膜的折叠，这可能导致心脏骤停。该并发症的估计发生率为1.6%。这种并发症的处理取决于球囊扩张或瓣膜置换术。本文讨论了一例78岁男性有严重症状性主动脉瓣狭窄的病例。在TAVR后，由于瓣膜内折，患者出现了心脏骤停，这突出了在TAVR并发症管理中需要提高警惕和改进干预策略。

引用次数: 0

Implementing Patient Protection Radiation Dose Alerts for Pediatric Cardiac Catheterization Examinations 在儿童心导管检查中实施患者防护辐射剂量警报。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102292

Elanchezhian Somasundaram PhD , Russel Hirsch MD , Samuel L. Brady MS, PhD , Karen S. Minsterman RN , Keith J. Strauss MSc

Background

Advancements in cardiac catheterization have improved survival for pediatric congenital heart disease patients, but the associated ionizing radiation risks necessitate ethical consideration.

Methods

This study presents an empirical model, developed from 3131 unique pediatric procedures, to establish alert levels based on a patient's lateral thickness of the thorax for various procedural categories during diagnostic or interventional cardiac catheterization. The model uses linear regression of logarithmic reference air kinetic energy released per unit mass (KERMA) and air KERMA area product, also referred to as dose area product, to set alert levels at the top 95% and 99% of patient data.

Results

Coefficients of the regression fits are provided for diagnostic and interventional procedural groups and fluoroscopic plane allowing any facility to scale the results of this study’s single facility data to model their practice’s unique procedural dose levels.

Conclusions

The proposed method allows institutions to tailor dose alert levels to their specific pediatric populations to reduce overexposure events.

背景：心导管术的进步提高了儿童先天性心脏病患者的生存率，但相关的电离辐射风险需要伦理考虑。方法：本研究提出了一个经验模型，从3131个独特的儿科手术中发展而来，在诊断或介入性心导管插入术期间，根据患者的胸腔外侧厚度建立不同手术类别的警报级别。该模型使用对数参考空气动能每单位质量释放（KERMA）和空气KERMA面积积（也称为剂量面积积）的线性回归，在患者数据的前95%和99%设置警报级别。结果：回归拟合系数提供了诊断和介入程序组和透视平面，允许任何机构缩放本研究的单个机构数据的结果，以模拟其实践的独特程序剂量水平。结论：建议的方法允许机构根据其特定的儿科人群定制剂量警报水平，以减少过度暴露事件。

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引用次数: 0

Coronary Function Testing: Seeking Answers for Refractory Chest Pain 冠状动脉功能测试：寻找顽固性胸痛的答案。

Journal of the Society for Cardiovascular Angiography & Interventions

Pub Date : 2024-12-01 DOI: 10.1016/j.jscai.2024.102437

Connor P. Tice MD, Kathleen E. Kearney MD, John E.A. Blair MD

引用次数: 0

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