[Evaluation of the incidence of radiodermatitis lesions in interventional cardiology]

Purpose: The percutaneous coronary interventions use large doses of ionizing radiation, particularly when treating complex lesions. The incidence of radio-induced skin lesions is poorly known. Our goal was to evaluate the frequency of occurrence of such lesions, as well as the factors that may contribute to a high radiation dose. The recommended DAP (dose-area product) cutoff for skin monitoring after percutaneous coronary interventions is 500Gy cm².

Patients and method: We prospectively studied the incidence of acute (after 5-7 days) and subacute (after 7 days to 6 months) skin lesions following angioplasty with a dose-area product (DAP) ≥200Gy cm² in patients who underwent coronary angioplasty in our center in 2013.

Results: Nine hundred and thirty three consecutive procedures were analyzed, of which 102 with a DAP ≥200Gy cm². Three patients presented an acute lesion. Two of these three patients also had subacute lesions. Another patient presented only a subacute lesion. 4.82% (95% CI: [0-10]) of the patients with a DAP ≥200Gy cm² developed radiodermitis lesions, or 0.47% (95% CI: [0-0.9]) of all the patients who underwent angioplasty. The Body Mass Index and the elective (as opposed to energy) procedures were independently associated with a procedure with a DAP ≥200Gy cm².

Conclusion: Radiodermatitis lesions occur for 4.82% of patients benefiting from procedures with a DAP ≥200Gy cm². We suggest the establishment of a DAP threshold for dermal monitoring of patients of 200Gy cm² per procedure instead of 500Gy cm².