Introduction:

Non-communicable chronic diseases are the leading cause of mortality worldwide. These diseases account for approximately 70% of global deaths [1]. Interventional radiology diagnoses and treats these conditions using minimally invasive procedures. However, high radiation doses may be associated with these procedures [2]. Cardiac catheterization (CAT) is a commonly used technique in interventional cardiology. This study will conduct a comparative dosimetric analysis among three interventional institutions performing CAT on adult patients, using air kerma-area product (PKA) and fluoroscopy time (FT) parameters.

Materials and Methods:

Data from the Health Surveillance database of Minas Gerais, collected between 2022 and 2023, were utilized. We analyzed data from 3 interventional radiology services, labeled A, B, and C, which conducted CAT procedures on adult patients. The collected parameters included: (i) procedure type; (ii) age; (iii) sex; (iv) weight; (v) height; (vi) PKA; (vii) K; and (viii) FT. Median values of PKA and FT were used as the standard reference for comparison.

Results:

Data analysis included a total of 5586 CAT procedures. Sex analysis revealed that men underwent CAT procedures more frequently, approximately 11% more than women, a trend consistent across all three services. Analysis of PKA (Gy.cm²) and FT (s) for CAT procedures showed significant variation. PKA ranged from 0.048 to 1712 Gy.cm², with a median of 42.36 Gy.cm² and a standard deviation of 343.42, indicating wide dispersion. FT ranged from 4 to 560 seconds, with a median of 161 seconds and a standard deviation of 120, indicating considerable variability.

Among the services, Service C exhibited the highest median PKA (48.8 Gy.cm²) and FT (182 seconds). Service A stood out with the lowest median FT (139 seconds) and the lowest median PKA (35.7 Gy.cm²). Service B had a median PKA of 44 Gy.cm² and FT of 180 seconds.

Conclusion:

The variability in PKA and FT values suggests significant differences in case complexity and clinical practices among the services. The high standard deviations of FT indicate that some procedures required longer times, possibly due to complications or more complex cases necessitating extended fluoroscopy times. These findings underscore the importance of standardizing procedures and continuous monitoring to minimize radiation exposure and optimize fluoroscopy times, thereby enhancing the safety and efficacy of catheterization procedures and reducing risks for patients. The observed variations also highlight the need for protocol adjustments in catheterization to accommodate varying case complexities.

Acknowledgments:

This work was supported by the Brazilian National Council for Scientific and Technological Development (CNPq, Projeto INCT/INAIS – 406303/2022-3 e CNPq Processo 308368/2022-3 – Bolsa Produtividade), Coordination for the Improvement of Higher Education Personnel (CAPES), and the State Agency for Research and Development of Minas Gerais (FAPEMIG).