Radiation exposure to patient's skin during percutaneous coronary intervention for various lesions, including chronic total occlusion

Background: Radiation skin injuries have been reported as a result of various procedures, so in the present study the patients' entrance skin dose (ESD) during percutaneous coronary intervention (PCI) was evaluated. Methods and Results: ESDs were assessed during 97 procedures (13 for chronic total occlusion (CTO), 14 for multivessel stenoses, 22 for single-vessel multiple stenoses, and 48 for single stenosis). The patients wore jackets that had 48 or 52 radiosensitive indicators placed on the back during the PCI procedures, with 8 other indicators placed on both upper arms. After the procedure, the color of the indicators was analyzed with a color measuring instrument, and the patients' ESDs were calculated from the color difference of the indicators. The average maximum ESDs of the patients were 4.5±2.8 Gy (median: 4.6 Gy) for CTO, 2.3±0.7 Gy (median: 2.4 Gy) for multivessel stenoses, 1.8±1.0 Gy (median: 1.5 Gy) for single-vessel multiple stenoses, and 1.4±0.9 Gy (median: 1.2 Gy) for single stenosis. Conclusions: Skin injury can occur during PCI, especially for CTO, so it is important to estimate each patient's ESD and attempt to reduce it.