X-rays allow physicians to detect and treat common cardiovascular conditions such as coronary artery disease, valve disease and other heart problems. There has been a continuous debate regarding the amount of radiation exposure an individual can receive undergoing X-rays. Now, new research demonstrates how to dramatically cut the amount of radiation a patient and medical personnel are exposed to during invasive cardiovascular procedures.
Chanjit Rihal, MD, chair of the Mayo Clinic's Division of Cardiovascular Diseases, composed a set of detailed modifications for the use of standard X-ray equipment. These adjustments dramatically cut down radiation exposure.
"Through our efforts, we were able to quickly cut the overall radiation exposure to patients by nearly half using simple but effective methods," Rihal said. "We think this program could serve as a useful model for other cath labs in the U.S."
According to Rihal, cardiologists rely on X-rays to provide real-time images of heart problems and guidance for procedures such as implanting stents, expanding narrowed arteries and aortic valve replacement. Though X-rays provide doctors with a sufficient amount of information to assist patients, it can be hazardous to an individual's health. Radiation exposure from X-rays can injure the skin if not administered carefully, and may also damage the DNA leading to an increase risk of certain cancers.
However, with the set of modifications Rihal hopes to reduce the exposure to radiation.
Rihal stated the amount of radiation used in a procedure should not exceed the minimum necessary. For example, currently medical personnel set the radiation output of their systems to a very low setting, reducing the amount of radiation dose to their patients. It should only be increased if higher-quality images are needed, such as during a critical portion of a procedure.
Practice-wide radiation safety is now incorporated when training fellows and junior faculty. The cath lab teams are also notified regarding the radiation doses that are administered to patients during each procedure and it is noted in the patient's medical record.
With the changes implemented by Mayo Clinic, researchers conducted a total of 18,115 procedures. Of all procedures, it was discovered there was a 40 percent reduction in radiation exposure, on average, over a three year period. A decrease in percutaneous coronary intervention, coronary angiography, non-cardiac vascular interventions and interventions to treat structural heart disease ranged from 34 to 53 percent.
"We need radiation to be able to see what we are doing in a patient, so X-ray imaging has a definite benefit, but excessive doses of radiation can cause problems," Dr. Rihal said. "These are good procedures. We just made them safer."
The study was published in the Journal of the American College of Cardiology: Cardiovascular Interventions.