Incidence of radiation-induced skin lesions after percutaneous coronary intervention - 10/11/15
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Résumé |
Background |
Percutaneous coronary interventions (PCIs) use significant doses of ionizing radiation, especially when treating complex lesions. Ionizing radiation may lead to adverse acute or delayed skin lesions in this setting, for which the incidence is not well known.
Purpose |
To assess the incidence of radiation-induced skin lesions following PCI.
Methods |
We conducted a prospective, observational, single-centre study on the incidence of radiation-induced skin lesions at 3–5days (acute) and at 6months (subacute) after PCI with a dose–area product (DAP)≥200Gy/cm2, between 1 January and 31 December 2013. Patients consenting to participate were given information on potential skin lesions and were interviewed at 5–7days and at 6months after the PCI.
Results |
In total, 1168 PCIs were performed; the radiation dose was available for 937 patients. Of these, 102 underwent PCI with DAP≥200Gy/cm2. High body mass index (BMI; OR 6.2, 95% CI 2.8–13.9) and elective (vs emergency) procedures (OR 2.0, 95% CI 1.1–3.4) were independently associated with DAP≥200Gy/cm2. Three patients (3%, 95% CI 0.6–8.4) were diagnosed with acute lesions (DAP of 485Gy/cm2, 205Gy/cm2, and 201Gy/cm2), two of whom also presented with subacute lesions following PCI with DAP of 485Gy/cm2 (Fig. 1) and 205Gy/cm2. One patient presented with a subacute lesion (DAP 280Gy/cm2) only. Four patients presented with a skin lesion, which represents 4% (95% CI 1.1–9.7) of patients with DAP≥200Gy/cm2 and 0.4% (95% CI 0.1–1.1) of all the patients who underwent PCI, irrespective of DAP dose.
Conclusions |
The incidence of radiation-induced acute and subacute skin lesions developing after PCI in this single-centre study was 4% in patients with DAP≥200Gy/cm2, with a total incidence of 0.4%. These data may suggest the need for systematic assessment of skin lesions after high-dose radiation PCI.
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Vol 64 - N° 5
P. 416-417 - novembre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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