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Efficiency of a minicourse in radiation reducing techniques: a pilot initiative to encourage less irradiating cardiological interventional techniques (ELICIT)
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  1. E Kuon1,
  2. K Empen2,
  3. D M Robinson2,
  4. A Pfahlberg3,
  5. O Gefeller3,
  6. J B Dahm2
  1. 1Department of Cardiology, Klinik Fraenkische Schweiz, Ebermannstadt, Germany
  2. 2Department of Internal Medicine, Ernst Moritz Arndt University, Greifswald, Germany
  3. 3Institute for Computer Sciences, Biometry and Epidemiology, Friedrich Alexander University, Erlangen-Nuremberg, Germany
  1. Correspondence to:
    Dr Eberhard Kuon
    Klinik Fraenkische Schweiz, Feuersteinstrasse 2, D-91320 Ebermannstadt, Germany; eberhard.kuonklinik-fraenkische-schweiz.de

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The reported mean dose–area product (DAP) received by patients from coronary angiography and percutaneous coronary intervention (PCI) is high and typically varies too greatly in invasive cardiology—that is, within 16–106 Gy × cm2 and 34–109 Gy × cm2, respectively.1 Skin erythema, chronic radiodermatitis, and musculocutaneous deep injury in conjunction with complex coronary interventions may result.1,2

The International Commission on Radiological Protection points out that, unfortunately, “Many interventionists are not aware of the potential for injury from procedures, their occurrence, or the simple methods for decreasing their incidence utilising dose control strategies”.2 Recently in clinical routine and with no negative diagnostic implications, effective dose reduction techniques enabled mean patient DAPs of 4.2 (1.6) and 6.7 (5.2) Gy × cm2 for elective coronary angiography and one vessel PCI, respectively.1,3

In realisation of the European Directive 97/43 that “Member States shall ensure that practitioners … have adequate theoretical and practical training for the purpose of radiological practices”,4 new European guidelines in that field have been established.5 We describe the contents of a training minicourse in less irradiating cardiac interventional techniques and its validation in clinical routine.

METHODS

Before and after the minicourse we analysed the following mean radiation parameters of 10 coronary angiographies, performed by each …

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