By Ever D. Grech
Univ. of Manitoba, Canada. useful reference for the interventional heart specialist and resident. Covers systems and significant subject matters, emphasizing readability, medical relevance, and present info. Halftone illustrations. past version: c1997.
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Doses received during diagnostic and therapeutic cardiac procedures. It also illustrates the inverse square law in which the intensity of radiation dose decreases as the square of the distance between the source and the operator. In other words, for each step back from the source there is a 4-fold decrease in radiation dose (Fig. 3). Even with protective lead shielding placed close to the primary beam the dose to the operator is not inconsiderable and varies at different body sites. The aim of lead coats is to protect sensitive parts of the body, the bone marrow being most sensitive.
Studies from our centres75 and the UK76 have shown that certain lesions are not as amenable to balloon angioplasty as others because of mechanical limitations, chronic occlusions, diffuse disease, eccentric, ostial and heavily calcified lesions. Flow-limiting dissections, which occur in about 3–5% of cases, were responsible for (almost) all of the untoward initial results of angioplasty, including acute myocardial infarction, emergency coronary artery bypass, surgery and death. However, these outcomes have been greatly improved by stenting.
Summary and conclusions In the 24 years since the introduction of percutaneous transluminal coronary angioplasty many thousands of patients have been treated. In recent years, especially with the addition of new balloon technology and new devices, very high success rates (>95%) and low complication rates (<3%) have been noted. Studies from our centres75 and the UK76 have shown that certain lesions are not as amenable to balloon angioplasty as others because of mechanical limitations, chronic occlusions, diffuse disease, eccentric, ostial and heavily calcified lesions.