Does the use of new intracoronary interventional devices prolong radiation exposure in the cardiac catheterization laboratory?

Objectives. The aim of this study was to the duration of radiation exposure associated with new percutaneous coronary interventional devices with that associated with convention balloon angioplasty. Background. Radiation exposure levels has been documented to be higher with coronary balloon angioplasty than with routine diagnostic coronary angiography. However, the effect of new interventional devices on radiation exposure has not been studied. Methods. Fluoroscopic and cineangiographic data from the Mayo Clinic cardiac catheterization laboratory data base of patients having single-segment coronary intervention during a recent 46-month period were retrospectively analyzed. Of 897 patients studied, 646 underwent balloon angioplasty, 138 directional coronary atherectomy (42 with adjunctive balloon angioplasty), 76 excimer laser angioplasty (50 with adjunctive balloon angioplasty) and 37 placement of an intracoronary stent (16 emergencies). Results. Duration of fluoroscopy during balloon angioplasty was 24 ± 18 min, which was longer than with directional atherectomy (18 ± 8 min; p = 0.001). Fluoroscopy time was 25 ± 17 min with laser angioplasty and 29 ± 15 min with elective stent placement (neither time was significantly different from that with balloon angioplasty). When atherectomy or laser angioplasty was performed with adjunctive balloon angioplasty or if emergency intracoronary stent placement was performed, the duration of fluoroscopy was significantly prolonged compared with balloon angioplasty alone. Conclusions. Fluoroscopy duration is not prolonged with the use of new interventional coronary devices compared with conventional angioplasty unless adjunctive balloon angioplasty is used or emergency stent placement is required.