Ces radiol. 2013, 67(2):153-158

Proposal and verification of standard procedures for the optimization of medical exposure of pelvic and lower extremities arteries in an interventional radiology in the Czech RepublicOriginal article

Martina Nováková^1,2, Filip Cihlář², Antonín Krajina³, Milouš Derner²

¹ Fakulta biomedicínského inženýrství ČVUT, Praha

² Radiologické oddělení, Masarykova nemocnice o.z., Krajská zdravotní a.s., Ústí nad Labem

³ Radiologická klinika LF a FN, Hradec Králové

Aim: The Purpose of this study, conducted in the Czech Republic and supported by the State Office for Nuclear Safety (SUJB), was to propose and verify a standard processes for interventional procedures on the pelvic and lower extremities arteries, specifically for percutaneous angioplasty, (PTA) which would lead, with the active cooperation of the medical staff, to an acceptable reduction of radiation exposure on patients and medical staff while maintaining sufficient diagnostic information.
In this communication, we present only a part of this study, which dealt with the intervention procedures on arteries of lower.

Method: In the period January-June 2011 were in four departments of regional and university hospitals processed data characterizing exposure to ionizing radiation in patients with diagnostic and intervention procedures on arteries of lower extremities from the exam protocols. Individual sites were compared, and those that had above-average dose was informed. After adjusting their way of using angiographic devices were in the next period July to December 2011 compared to dose again.

Results: After the introduction of the standard procedure for interventional procedures on the lower extremities arteries, the average fluoroscopy time was reduced to 14.2 min. per procedure, the number of frames per examination was reduced to 16.2, the average entrance surface dose decreased to 144 mGy (400 mGy in years 2009-2010) and the dose area product decreased to 40.02 Gycm² (92 Gycm² in years 2009-2010).

Conclusion: During 2011 the required data were collected from a total of 311 examinations. After the introduction of the standard procedure for interventional procedures on the lower extremities arteries to all monitored medical departments the reduction of the entrance surface dose and the dose area product by about 50% occurred, except for at the reference medical department.

Keywords: interventional radiology, percutaneous angioplasty (PTA), area dose product (DAP), entrance surface dose (ESD)

Accepted: April 16, 2013; Published: June 1, 2013  Show citation