ABSTRACT
Objective To evaluate the clinical safety and feasibility of dual-axis rotational coronary angiography (XperSwing) in diagnosing coronary artery disease in aged Chinese patients through comparing it with standard coronary angiography. Methods During the period from April 2011 to December 2012, a total of consecutive 151 patients with an age ≥ 65 years underwent diagnostic coronary angiography at authors’ hospital. The patients were randomly divided into the standard angiography group (n = 75) and XperSwing group (n = 76). The used dose of contrast, radiation exposure dose and operation time of each patient were recorded. Besides, the occurrence of procedure-related symptoms and arrhythmia during the procedure was recorded, and the blood pressure (BP), heart rate (HR) and creatinine level immediately before-and-after the procedure were estimated. The number of additional acquisition needed to be performed was used to evaluate the efficacy of the two methods. Results Coronary angiography was successfully accomplished in all patients of the two groups, and no significant difference in the number of additional acquisition existed between the two groups (P > 0.05). The used dose of contrast in XperSwing group was reduced by 44% when compared with that in the standard angiography group, i.e. (29.28 ± 5.06) ml vs(22 755.97 ± 11 239.22) mGycm2, (P 0.05). No contrast- induced nephropathy occurred in both groups, although the difference in postoperative changes of creatinine level between the two groups was statistically significant (P < 0.05). Conclusion This study indicates that in diagnosing coronary artery disease in aged Chinese patients, dual-axis rotational coronary angiography is more safe and effective than conventional coronary angiography, as XperSwing can significantly reduce the contrast dose and radiation exposure for the patients.
ABSTRACT
Objective To compare radiation doses to patients between rotational angiography and standard angiography.Methods According to different modes,our experiment was divided into RA (Dual-axis Rotational Angiography) group and SA (Standard Angiography) group.The latter was divided into 3 subgroups (SA1,SA2 and SA3) in terms of different time of cine.The procedure time and the position were controlled by the order preset into the machine.Each group consisted of 10 repeated operations with a unique phantom to simulate the true patients.The radiation doses were measured by using dose meter provided by the machine and TLD system; the means of the data were compared.Results The mean of total accumulated DAP and AK in group RA were 3 061.6 mGy·cm2 and 64.2 mGy,respectively,compared with group SA1 (4 213.9 mGy·cm2 and 85.5 mGy),SA2 (6 436.0 mGy·cm2 and 112.2 mGy),SA3 (12 810.4 mGy·cm2 and 243.7 mGy).The mean of accumulated dose in group RA was 37.70 mGy,higher than group SA1 (26.56 mGy) but lower than group SA2 (46.86 mGy) and SA3 (77.79 mGy).The gap between highest dose and lowest dose in RA group was insignificant whereas significant in the subgroups of SA.Conclusions In comparison with conventional angiography,the dual-axis rotational angiography has the potential to reduce radiation exposure of patients significantly so as to prevent skin radiation injures.
ABSTRACT
Objective To observe the clinical safety of dual axis rotational coronary angiography (DARCA) in the diagnosis of coronary artery disease in Chinese population.Methods From March to December in 2010,74 patients undergoing diagnostic DARCA were enrolled.The improved isocentering technique was adopted in 34 of the patients at the end of the study during DARCA.Blood pressure,heart rate and symptoms were recorded immediately before-and-after contrast injections.Contrast dose,radiation exposure and procedure time for DARCA were recorded.Continuous variable data were analyzed using Student＇s t test,if normality assumption was violated,rank sum test would be used.Categorical variables were analyzed using x2 test.Results ( 1 ) Clinical safety:There was no chest pain documented during or immediately post-injection for all patients.Only 1 patient ( 1 ％ ) had an attack of ventricular tachycardia immediately after the contrast injection and then relieved automatically.Pre and post-injection systolic blood pressure values of left coronary artery were statistically different [ ( 116 ± 20 ) mm Hg vs.( 111 + 18) mm Hg( 1 mm Hg =0.133 kPa),t =3.303,P =0.001 ],and heart rates differed,too [ 73 ( 65- 84)bpm vs.71(64-78) bpm,Z =-4.789,P =0.001 ],but that imposed no clinical significance.(2)Contrast dose,radiation dose and procedure time:The mean contrast utilization,radiation dose and procedure time for DARCA were 28 (25-34) ml,8979 ( 6733-12 363 ) mGycm2 and 200 (164-270) s.Compared with conventional DARCA,improved isocentering technique during DARCA had less radiation exposure and procedure time in left coronary artery angiography and the whole coronary artery angiography [ left coronary artery angiographic radiation exposure:4004 (2932-5772) mGycm2 vs.5808 (4798- 8838) mGycm2,Z =-3.471,P =0.001 ;total radiation exposure:(8116 +2493) mGycm2 vs.( 11 371 ±4122) mGycm2,t =-4.176,P =0.001 ; left coronary artery angiographic procedure time:120 ( 80-180)s vs.150(126-214) s,Z =- 2.836,P =0.005; total procedure time:180 (139-240) s vs.220( 186-308 )s,Z =-3.004,P =0.003 ],but there was no statistically difference in contrast utilization [30(25-35) ml vs.27(25-34)ml,Z=-0.906,P=0.365].Conclusion This study demonstrates clinical safety of DARCA in the diagnosis of coronary artery disease in Chinese population.Compared with conventional isocentering technique of DARCA,improved isocentering technique can significantly reduce radiation exposure and procedure time on the basis of simplified operation,and replace the conventional isocentering technique,but randomized double-blind controlled studies should be conducted.