Patient Radiation Dose During Bifurcation Percutaneous Coronary Intervention

Abstract

BACKGROUND There is limited information regarding patient radiation dose during bifurcation percutaneous coronary interventions (PCI). METHODS We examined the association of clinical and angiographic characteristics with patient air kerma (AK) radiation dose during 787 PCIs involving 916 bifurcation lesions performed at 5 centers between 2014 and 2024 from PROGRESS-BIRFUCATION (Prospective Global Registry for the Study of Bifurcation Lesion Interventions; NCT05100992).RESULTS The mean and median radiation dose was 1.72 1.21 Gy and 1.40 Gy (Q1-Q3: 0.90-2.16 Gy) respectively. Approximately 25.0% of patients received >2.16 Gy of AK radiation (high radiation dose group). There were no significant differences in side branch occlusion occurrence (17.4% vs 16.3%; P ¼ 0.813), technical success (93.0% vs95.6%; P ¼ 0.141), and major adverse cardiac events (6.1% vs 4.6%; P ¼ 0.396) between high and low radiation dose cases. On univariable linear regression analysis, male gender (P < 0.001), body mass index (BMI) (P < 0.001), diabetes mellitus (P ¼ 0.007), prior PCI (P ¼ 0.021), prior coronary artery bypass graft (P ¼ 0.005), proximal main vessellesion length (P ¼ 0.008), proximal main vessel calcification (P ¼ 0.012), distal main vessel lesion length (P ¼ 0.004), side branch lesion length (P < 0.001), side branch calcification, and presence of true bifurcation (P ¼ 0.021) were associated with higher radiation dose, whereas age (P ¼ 0.033) was associated with lower radiation dose. Onmultivariable linear regression analysis, gender, BMI, distal main vessel lesion length, and side branch calcification were independently associated with higher radiation dose (Table).CONCLUSION We found several patient and angiographic characteristics, including gender, BMI, distal main vessel lesion length, and side branch calcification, independently associated with increased patient radiation dose during bifurcation PCI.