Optimization of percutaneous coronary intervention through lower frame rates angiogram

摘要

Background Coronary artery disease(CAD)is a leading cause of mortality worldwide.Percutaneous coronary intervention(PCI)is a standard treatment for CAD,yet the radiation exposure associated with this procedure can pose significant risks to both patients and healthcare professionals.With the aim to optimize this procedure,we studied the effects of different exposure rates on radiation dose,fluoroscopy time,and procedural complications.Methods A total of 441 consecutive patients who underwent coronary angiography and subsequent PCI treatment from January 2020 to December 2021 were included in this study.Baseon the fluoroscopy frame rates used during the procedure,patients were divided into two groups,which included a standard dose protocol(SDP)group that used15 frames per second(FPS)and a low dose protocol(LDP)group that used 7.5 FPS.Then the impact of different fluoroscopy frame rates on total air kerma(AK),procedure time,fluoroscopy times(FT),and procedural complications in patients undergoing PCI were evaluated.Results Our data indicated that LDP group had a significantly lower AK,indicative of a reduced radiation dose,in comparison to SDP group.Although the procedure time and FT were slightly longer in the LDP group,this increase was not statistically significant.Moreover,the rate of intraoperative complications in the LDP group was not higher than that in the SDP group.In a subgroup of patients who underwent intravascular ultrasound(IVUS)within the LDP group,we observed further reductions in radiation exposure and FT.Conclusions The use of reduced fluoroscopy frame rates and adjunctive IVUS during PCI procedures can be a viable approach to minimizing radiation exposure without compromising procedure success or patient safety.