Implementation of a Low Frame-Rate Protocol and Noise-Reduction Technology to Minimize Radiation Dose in Transcatheter Aortic Valve Replacement

Davide Maccagni, Luciano Candilio, Azeem Latib, Cosmo Godino, Alaide Chieffo, Matteo Montorfano, Antonio Colombo, Lorenzo Azzalini

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

OBJECTIVES: Limiting radiation exposure is necessary in radiological procedures. This study evaluates the impact of a radiological low frame-rate protocol in a standard angiographic system and the implementation of a noise-reduction technology (NRT) on patient radiation exposure during transcatheter aortic valve replacement (TAVR). METHODS: Transfemoral TAVR procedures performed between February 2016 and February 2017 were analyzed according to two angiographic systems, Standard and NRT, and further divided in four subgroups: (1) Standard 15 frames per second (fps) with 15 fps for both fluoroscopy and cine acquisitions; (2) Standard 7.5 fps with 7.5 fps for both fluoroscopy and cine acquisitions; (3) NRT 15 fps with 15 fps for both fluoroscopy and cine acquisitions; and (4) NRT 7.5 fps with 15 fps for fluoroscopy and 7.5 fps for cine acquisitions. Study endpoints were kerma area product (KAP) and cumulative air kerma at interventional reference point (AK at IRP). Results. Significant differences were found in KAP (153 Gy·cm2 [IQR, 95-234 Gy·cm2] vs 78.3 Gy·cm2 [IQR, 54.4-103.5 Gy·cm2]; P<.001) and AK at IRP (1.454 Gy [IQR, 0.893-2.201 Gy] vs 0.620 Gy [IQR, 0.437-0.854 Gy]; P<.001) between Standard system and NRT. Within the procedures conducted with Standard protocol, a reduction of KAP and AK at IRP was found between Standard 15 fps and Standard 7.5 fps groups (184 Gy·cm2 [IQR, 128-262 Gy·cm2] vs 106.8 Gy·cm2 [IQR, 76.87-181 Gy·cm2] [P<.01] and 0.973 Gy [IQR, 0.642-1.786 Gy] vs 0.64 Gy [IQR, 0.489-0.933 Gy] [P<.01], respectively). CONCLUSIONS: The present study suggests that the low frame-rate protocol in Standard system and NRT implementation allows a marked reduction of patient radiation exposure in TAVR procedures.

Original languageEnglish (US)
Pages (from-to)169-175
Number of pages7
JournalJournal of Invasive Cardiology
Volume30
Issue number5
StatePublished - May 2018
Externally publishedYes

Keywords

  • radiation dose
  • transcatheter aortic valve implantation
  • transfemoral

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Implementation of a Low Frame-Rate Protocol and Noise-Reduction Technology to Minimize Radiation Dose in Transcatheter Aortic Valve Replacement'. Together they form a unique fingerprint.

Cite this