Oct 29, 2015 - who underwent both cardiac catheterization and cranial-CT during the ... Results: Transradial approach increased from 0.7% in 2006 to 75% in ...
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Interventional cardiology
P1263 | BEDSIDE Clinical characteristics, procedural and clinical outcome of patients treated with PCI for definitive stent thrombosis: a 12 years single centre experience
P1261 | BEDSIDE Prevalence of high and very high radiation doses to patients during percutaneous coronary interventions J.L. Georges 1 , L. Belle 2 , L. Orion 3 , S. Elhadad 3 , X. Marcaggi 3 , F. Funck 3 , F. Vinchon 3 , C. Maccia 1 , B. Livarek 1 , S. Cattan 3 on behalf of RAY’ACT investigators. 1 CH de Versailles, Le Chesnay, France; 2 CH d’Annecy and RENAU, Annecy, France; 3 Collège National des Cardiologues des Hôpitaux, Paris, France Purpose: Interventional coronary procedures (ICP) are associated with high radiation doses to patient. A skin entrance dose of >3 Grays (Gy), usually associated with an Air Kerma at reference point (Ka,r) of >5 Gy, and a Dose-Area Product (DAP) of >500 Gy cm2 , is considered as a threshold for deterministic effects (radiodermatitis), and a potential trigger for clinical follow-up. Data from large populations concerning the prevalence of high levels of exposure during ICPs are lacking. The purpose of this nationwide, multicentre survey was to evaluate current practices for patient radiation protection (RP) in French non-university public hospitals, which represent >30% of the national activity for ICP, and 60% of the emergency cases. Methods: RP parameters from 31 066 coronary angiographies (CAs) and 25 356 percutaneous coronary interventions (PCIs) performed at 44 centres during 2010, routinely registered were extracted and retrospectively analysed. Emergency and complex procedures, such as PCI for acute STEMI, chronic total coronary occlusion (CTO), or grafts lesions, were not excluded. Extreme values were validated and/or corrected by centres. DAP and Ka, r, more likely to reflect skin dose, were analyzed. Results: Table shows the prevalences of CAs and PCIs delivering high radiations doses (DAP >3-fold the Reference Levels [45 Gy.cm2 for CA, and 94 for PCI, respectively], and Ka,r >3 Gy), and very high doses (DAP >500 Gy.cm2 , and Ka,r >5 Gy).
Dose Area Product >X3 RL >300 Gy.cm2 >500 Gy.cm2 Total Air Kerma >3 Gy >5 Gy
nephropathy (CIN) in patients undergoing contemporary Percutaneous Coronary Intervention (PCI). Background: CIN is a common complication of PCI and is associated with an adverse short and long term outcome. Previously described risk scores for predicting CIN either have modest discrimination or include procedural variables and thus cannot be applied for pre-procedural risk stratification. Methods: Random Forest models were developed utilizing 46 pre-procedural clinical and laboratory variables to estimate the risk of CIN in patients undergoing PCI. The 15 most influential variables were selected for inclusion in a reduced model. Model performance estimating risk of CIN and new requirement for dialysis (NRD) was evaluated in an independent validation dataset using area under the ROC curve (AUC), with net reclassification improvement (NRI) used to compare full and reduced model CIN prediction after grouping in low, intermediate, and high risk categories. Results: Our study cohort was comprised of 68,573 PCI procedures performed at 46 hospitals between January 2010 and June 2012 in Michigan of which 48,001 (70%) were randomly selected for training the models, and 20,572 (30%) for validation. The models demonstrated excellent calibration and discrimination for both endpoints (CIN AUC: full model 0.85, reduced model 0.84, p for difference
