Impact of Low Frame Rate Fluoroscopy and Cine-angiography on Reducing Operator and Patient Dose

NCT ID: NCT02574949

Last Updated: 2015-10-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-31

Study Completion Date

2016-07-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Stable Angina Unstable Angina Acute Coronary Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Conventional rate fluoroscopy

Radiation: 15 FPS Cine 15 PPS

Group Type ACTIVE_COMPARATOR

Radiation: 15 FPS Cine 15 PPS

Intervention Type RADIATION

Radiation 15 FPS Cine 15 PPS

Intermediate frame rate 7.5 fps

Radiation: 7.5 low Frame rate

Group Type EXPERIMENTAL

Radiation: 7.5 low Frame rate

Intervention Type RADIATION

Radiation: Frame rate 7.5 FPS, Cine 15 PPS

Low frame rate

Low Cine 10 PPS

Group Type EXPERIMENTAL

Low Cine

Intervention Type RADIATION

Radiation: Frame rate 7.5 FPS, Cine 10 PPS

Interventions

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Radiation: 15 FPS Cine 15 PPS

Radiation 15 FPS Cine 15 PPS

Intervention Type RADIATION

Radiation: 7.5 low Frame rate

Radiation: Frame rate 7.5 FPS, Cine 15 PPS

Intervention Type RADIATION

Low Cine

Radiation: Frame rate 7.5 FPS, Cine 10 PPS

Intervention Type RADIATION

Other Intervention Names

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Conventional Low rate fluoroscopy Low pulse rate Cine

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing elective or urgent cardiac catheterisation with or without ad-hoc PCI or planned PCI in the pre-specified catheterisation laboratories.

Exclusion Criteria

* Patients who undergo procedures other than diagnostic coronary angiography or intervention (e.g. electrophysiological procedures).
* Patients participating in other research study requiring higher cine angiography.
* ST-elevation Myocardial Infarction
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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Vladimír Džavík

Director of Research and Innovation-Interventional Cardiology and Coronary Intensive Care Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Vladimir Dzavik, MD, FRCPC

Role: PRINCIPAL_INVESTIGATOR

UHN, Toronto, Canada

Locations

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University Health Network - Peter Munk Cardiac Centre

Toronto, Ontario, Canada

Site Status

Countries

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Canada

Central Contacts

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Divyesh Sharma, MSc,MRCP

Role: CONTACT

001-647-961-9336

Ashish H Shah, MD, MD(Res)

Role: CONTACT

001-416-835-2822

Other Identifiers

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15-8832-AE

Identifier Type: -

Identifier Source: org_study_id

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