经下腔静脉放置冠状静脉窦电极导管对操作者放射剂量影响的研究

Objective To evaluate and compare the dosages of operator-incurred-radiation during the implantation of coronary sinus (CS) catheter between the approaches through inferior vena cava (IVC) with the steerable catheter and through supra vena cava (SVC) with the fixed curve catheter. Methods Two hundred and two patients were divided into two groups according to the different approaches of CS catheter insertion. IVC group (n = 122) :a deca-polar catheter with steerable curve was placed into CS through the femoral vein and the IVC. SVC group (n =80) :a fixed curve deca-polar catheter was inserted into CS through the jugular vein and the SVC. There was no obvious difference in gender, age, and echocardiogram between the two groups. All procedures were performed by the same three operators. The exposure time of each case and the dosage of operator-incurred-radiation during the procedure were measured. Results The catheters were positioned successfully inl20 patients in the IVC group and in all patients in the SVC group. The 2 failured in the IVC group were also failed in by attempting through SVC with fixed curve catheter. There was no significant difference in the exposure time between IVC group and SVC group[( 105 ± 12)s and ( 108 ± 19)s,P =0. 925]. The per sec operator-incurred-radiation was 0. 25 × 10-2 uGy/s in WC group and 1.38 × 10 -2 uGy/s in SVC group. This lead to significant decrease in the dosage of operator-incurred-radiation in IVC group[(0. 30 ± 0. 04) uGy vs ( 1.49 ±0. 27) uGy,P ＜ 0. 001]. No cardiac or vascular complication was observed in both groups. Conclusions Insertion of coronary sinus catheter through IVC with the steerable catheter is associated with significantly less radiation than that through SVC with the fixed curve catheter without increasing time of the procedure.

The impact on operator-incurred-radiation of coronary sinus catheter insertion through inferior vena cava approaches