An estimate of the collective dose to the European population from cardiac X-ray procedures

There have been significant advances in interventional cardiology in recent years that have resulted in an increase in the frequency of both diagnostic and therapeutic X-ray-guided procedures. The number of coronary angiograms, percutaneous transluminal coronary angioplasties (PTCAs) and coronary stent procedures, as well as pacemaker insertions, has increased across Europe. X-ray-guided procedures are used in the treatment of complex cardiac problems and often involve the use of extended fluoroscopy times and the acquisition of a large number of images. There is increasing concern about the dose levels from these procedures, but their impact on the population dose is less well known. In this paper, the number of coronary procedures in various European countries is estimated and the population dose deduced. In addition, the total collective effective doses for cardiac procedures for various European countries have been estimated. In 2006, the estimated average number of coronary angiograms was 5045 per million population, 1511 per million for PTCAs, 836 per million for stents and 918 per million for pacemaker insertions in the 29 countries studied. The estimated population dose from coronary angiograms, pacemaker insertions, PTCA and stent procedures was 27,000 man Sv.