An eye on imaging: How to limit radiation exposure during TAVR procedures
Low-dose imaging protocols can effectively limit radiation exposure during transcatheter aortic valve replacement (TAVR) procedures without impacting patient outcomes, according to new findings published in the American Journal of Cardiology.
With TAVR being recommended for more and more patients, the study’s authors observed, “the impetus to reduce the radiation burden is compelling.”
Researchers tracked data from more than 600 patients who received care at a high-volume facility in Munich, Germany. More than 300 patients were treated from January 2014 to February 2016, receiving usual care, and their outcomes were compared with more than 300 patients who received care guided by a low-dose imaging protocol from August 2017 to March 2019.
The low-dose imaging protocol used in this analysis followed the “as low as reasonably achievable” radiation optimization principle, designed to expose patients to a minimal amount of radiation during any given procedure. The protocol emphasizes the importance of everything from fluoroscopy settings to less obvious details such as table height.
Overall, the authors wrote, following a low-dose protocol is associated with “a large reduction in median DAP, in a propensity score-matched population, without compromising the results of the intervention.” Additional factors linked to a heightened DAP included heavier patient weights, longer procedure times and longer fluoroscopic times.
“Importantly, use of the low-dose protocol was not associated with a significant reduction in device success or an increase in complications,” wrote Jonathan M. Michel, MD, a cardiologist at Technical University Munich in Germany, and colleagues.
The full analysis is available here.