Advances in Interventional Cardiology
eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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3/2025
vol. 21
 
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abstract:
Original paper

Patient radiation dose and contrast usage impacted by assisted coronary angiography technologies: fractional flow reserve, instantaneous wave-free ratio, intravascular ultrasonography, and optical coherence tomography

Christos N. Bousis
1
,
Pavlos Karanikis
2
,
Thanasis Kosovitsas
2
,
Anna Kotsia
2
,
Eleni Tzima
2
,
Evaggelia Kalampoki
2
,
Polyxeni Oikonomou
2
,
Evgenia Pappa
2

  1. Department of Medical Physics, General Hospital of Ioannina “CHATZIKOSTA”, Ioannina, Greece
  2. Cardiology Clinics, Haemodynamics Laboratory, General Hospital of Ioannina „CHATZIKOSTA”, Ioannina, Greece
Adv Interv Cardiol 2025; 21, 3 (81): 314–323
DOI: https://doi.org/10.5114/aic.2025.154251
Online publish date: 2025/09/15
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Introduction:
Although coronary angiography adjunctive technologies (AT) provide valuable insights into lesion severity and characteristics, their use increases radiation and contrast exposure.

Aim:
To assess the impact of AT on patients’ radiation dose, irradiation and procedural times, and contrast usage.

Material and methods:
Dose-area product (DAP), patient effective dose, irradiation and procedural times, and contrast usage were compared between two groups, each comprising 258 patients who underwent coronary angiography with AT (AT group) or without (NoAT group). Multivariate analysis was performed on the whole patient group and the AT group to identify significant predictors of elevated DAP and contrast.

Results:
Compared to the NoAT group, DAP, patient effective dose, and contrast usage increased by 70–73%, while irradiation and procedural times were 120% and ~135% longer, respectively, in the AT group. Whole patient group analysis revealed that AT use was the strongest predictor of increased DAP and contrast usage (1.7; 95% CI: 1.6–1.8; p < 0.001). Higher contrast usage was observed in patients with a history of CABG (1.4; 95% CI: 1.2–1.7; p < 0.001). In AT group analysis, both DAP and contrast usage were significantly associated with gender, AT process type, number of AT procedures, and procedural time. Male gender and ad-hoc AT processes were the strongest predictors of elevated DAP and reduced contrast usage, respectively (1.2; 95% CI: 1.1–1.3; p < 0.001 and 0.8; 95% CI: 0.7–0.9; p < 0.001). Procedures via right radial artery access were linked to reduced contrast usage (0.9-fold; 95% CI: 0.8–1.0; p < 0.001). Both analyses showed that DAP increased by 1.04–1.05 per unit rise of BMI (95% CI: 1.0–1.1; p < 0.001).

Conclusions:
In real-world clinical settings, the use of AT led to significant increases in patients’ radiation dose, irradiation and procedural times, and contrast usage.

keywords:

analysis, dose-area product, adjunctive technologies, contrast usage
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