Incidence of radiation-induced skin lesions after percutaneous coronary intervention

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• 作者：A. Paziuc¹ ; L. Mangin¹ ; A. Ispas¹ ; M. Raţă¹ ; B. Lafitte¹ ; H. Madiot¹ ; S. Vanwalleghem¹ ; C. Ricard¹ ; J.-L. Georges² ; L. Belle¹ ; ^{loic.belle@wanadoo.fr" class="auth_mail" title="E-mail the corresponding author}
• 刊名：Annales de Cardiologie et d'Angeiologie
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：64
• 期：5
• 页码：416-417
• 全文大小：430 K

文摘

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 3–5 days (acute) and at 6 months (subacute) after PCI with a dose–area product (DAP) ≥ 200 Gy/cm², between 1 January and 31 December 2013. Patients consenting to participate were given information on potential skin lesions and were interviewed at 5–7 days and at 6 months 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 ≥ 200 Gy/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 ≥ 200 Gy/cm². Three patients (3%, 95% CI 0.6–8.4) were diagnosed with acute lesions (DAP of 485 Gy/cm², 205 Gy/cm², and 201 Gy/cm²), two of whom also presented with subacute lesions following PCI with DAP of 485 Gy/cm² (Fig. 1) and 205 Gy/cm². One patient presented with a subacute lesion (DAP 280 Gy/cm²) only. Four patients presented with a skin lesion, which represents 4% (95% CI 1.1–9.7) of patients with DAP ≥ 200 Gy/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 ≥ 200 Gy/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.