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Radiation hazards for the patient in cardiological procedures
  1. P WILDE,
  1. K SLACK
  1. Department of Clinical Radiology
  2. Department of Medical Physics & Bioengineering *
  3. United Bristol Healthcare Trust
  4. Bristol, UK
  6. Imaging Team
  7. Department of Health

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The radiation dose to both staff and patients in interventional cardiology and radiology procedures is high compared to diagnostic procedures, particularly in the cardiological techniques of percutaneous coronary intervention (PCI) and radiofrequency ablation as well as developing techniques such as direct myocardial revascularisation. In considering the potential harmful effects of radiation it is necessary to consider effects on the patients themselves as well as the staff performing the procedure. There is considerable experience relating to the exposure of staff and increasing awareness of the importance of radiation protection for the staff and patients. Regulations covering both groups have been in place for 10–15 years. The aim of this article is to review the radiation hazards to the patient and the radiation protection measures taken to ensure that the risk to the patient is kept as low as reasonably practicable. In addition it will review the newly implemented Ionising Radiation Regulations.

Radiation biology

There are two main biological effects of ionising radiation: deterministic and stochastic. Deterministic effects are those in which the number of cells lost in an organ or tissue is so great that there is a loss of tissue function. The harm will not occur below a threshold and above this the severity of the effect will increase with dose. Skin erythema and ulceration are examples of deterministic effects. Stochastic effects occur if an irradiated cell is modified rather than killed and then goes on to reproduce. The result may be the manifestation of a cancer after a prolonged and variable delay called the latent period. Stochastic effects do not appear to have a threshold and the probability of the effect occurring is related to the radiation dose. The International Commission for Radiation Protection (ICRP), an international professional body, produce recommendations which are the basis for the conceptual framework and key …

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