Minimization of radiation dose exposure during a PCI procedure
Year: 2016
Type: dissertation
Abstract: Introduction: One of the most common causes of death in Sweden is cardiovascular disease. The disease is mainly caused by reduction in size of the arterial vessels in the heart which disturb the blood flow supplying oxygen to the heart. Narrowed blood vessels are often treated with a method called Percutaneous Coronary Intervention (PCI). When performing a PCI procedure, a plastic tube called a catheter is used. This catheter is often equipped with a balloon in the end, that can be inflated by the doctor at the desired location in the vessel. The catheter is guided through the arteries up to the narrowed vessel and the narrowing is opened by inflating the balloon. The guidance of the catheter is performed using X-rays. The X-rays used in the examination may lead to devastating injuries for both the patient and the staff who work in the examination room if they are not accurately protected. Aim: The aim of this thesis is to find ways to reduce radiation dose during an interventional procedure. The improvements were found by investigating the workflow and the technical factors that the clinic was working with when this thesis was initiated. Method: The thesis is divided into three different parts; a litterature study, a pre-study and a pilot study. The literature study had the aim to find out which factors affect the dose during a PCI procedure. In the pre-study a number of parameters were tested on the basis of both image quality and dose. The goal of the pre-study was to investigate suitable parameters that could be changed and used in the pilot study. In the pilot study a new dose protocol was implemented in the machine and used when examining the patients. A total of 70 patients were evaluated based on procedure type, physiological parameters of the patient and the dose delivered during the procedure. These parameters were then compared with retrospective data. Both the pre-study and the pilot study were performed at Vrinnevi Hospital in collaboration with GE Healthcare. Conclusion: The results of the pilot study showed no significant differences between retrospective data and the data received after implementation of the new protocol. However significant results were not expected due to the small sample size. This work can be used as a proposal for a larger pivotal study and demonstrates the importance of constantly working to minimize the dose delivered during a PCI examination.
Author: Melker Hagelberg
Language: English
Topic: Radiation Dose and Imaging
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2502749871