Acute Coronary Syndrome Clinical Trial
Official title:
Impact of Low Frame Rate Fluoroscopy and Cine-angiography on Reducing Operator and Patient Radiation Dose and Impact on Image Quality During Cardiac Catheterization
The investigators sought to investigate the efficacy of low frame rate (fluoroscopy at 7.5 frames per second (FPS) and Cine at 10 pulse per second (PPS) vs. conventional (15 FPS and 15 PPS) on radiation dose to the patient and the operator during coronary angiography and intervention. In addition, investigators sought to qualitatively assess the effect, if any, of the low frame rate on angiographic image quality.
Minimizing radiation exposure to patient and the operator is considered one of the primary
safety concerns in the catheterization laboratory. Patients undergoing diagnostic
angiography +/- ad hoc PCI or planned PCI, will be randomised to conventional settings (15
FPS and 15 PPS) or low frame rate settings (7.5 FPS and 15 PPS) or low Cine settings (7.5
FPS and 10 PPS). The patient radiation dose, patient radiation dose area product (DAP), and
fluoroscopy time will be measured.
Statistical Analysis:
Demographic and procedural variables will be presented as percentage (categorical variable)
or mean ± SD (continuous variable). Patients will be randomized into three arms - a control
arm and two intervention arms. The angiographic radiation protocol will adhere to standard
practice in both fluoroscopy and cine images at 15 frames/second. The intervention arm will
consist of two groups. Group 1 with fluoroscopy images set at 7.5 frames/second and cine
images set at 15 frames/second and group 2 with fluoroscopy set at 7.5 frames/second and
cine set at 10 frames/second.
Sample size calculations are based on assuming a reduction in radiation dose in group 1 of
10% and in group 2 of 20%. At 5% significance and 80% power, a sample size of 200 patients
will be required in each intervention arm. Allowing for a 10% attrition rate, a sample size
of 220 patients will be required in each intervention arm with 100 patients in the control
arm.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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