C-arm rotation as a method for reducing peak skin dose in interventional cardiology

Research output: Contribution to journalArticle

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Abstract

Purpose: Prolonged interventional cardiology (IC) procedures may result in radiation-induced skin injury, a potentially preventable cause of patient morbidity. Rotating the C-arm during an IC procedure may reduce this risk, although the methods by which the technique can be practically applied remains unexplored. A previous study demonstrated that C-arm rotation often increases peak skin dose (PSD) in interventional radiology procedures. The purpose of this study was to determine whether C-arm rotation reduces the PSD in IC procedures and, if so, under what circumstances. Materials and methods: Simulations were performed using a numerical ray-tracing algorithm to analyse the effect of C-arm rotation on PSD across a range of patient sizes, C-arm configurations and procedure types. Specific data from modern fluoroscopes and patient dimensions were used as inputs to the simulations. Results: In many cases, modest C-arm rotation angles completely eliminated overlap between X-ray field sites on the skin. When overlap remained, PSD increases were generally small. One exception was craniocaudal rotation, which tended to increase PSD. C-arm rotation was most effective for large patients and small X-ray field sizes. Small patients may not benefit from C-arm rotation as a procedural modification. The use of a prophylactic method where the C-arm was rotated between small opposing oblique angles was effective in reducing PSD. Conclusions: With the exception of rotation to steep craniocaudal angles, rotating the C-arm reduces PSD in IC procedures when used as either a procedural modification or a prophylactic strategy. Tight collimation increases the benefit of C-arm rotation.

Original languageEnglish (US)
Article numbere000141
JournalOpen Heart
Volume1
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Cardiology
Skin
X-Rays
Interventional Radiology
Radiation
Morbidity
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

C-arm rotation as a method for reducing peak skin dose in interventional cardiology. / Pasciak, Alexander; Bourgeois, Austin; Jones, A. Kyle.

In: Open Heart, Vol. 1, No. 1, e000141, 01.01.2014.

Research output: Contribution to journalArticle

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