Skip to main content
Clinical Cardiology logoLink to Clinical Cardiology
. 2008 Apr 10;31(4):145–147. doi: 10.1002/clc.20204

X‐ray Burns—Painful, Protracted, and Preventable

Ronald E Vlietstra 1,, Louis K Wagner 2
PMCID: PMC6653362  PMID: 18404681

Abstract

Very high doses of x‐ray may produce deep burns in the backs of patients having fluoroscopically guided cardiac interventional procedures. While these incidents are uncommon they can be prevented by judicious limitation of fluoroscopy and timely repositioning of the x‐ray tube. Better education and improved methods for dose mapping should make these distressing complications a thing of the past. Copyright © 2008 Wiley Periodicals, Inc.

Keywords: radiation injury, x‐ray burns, percutaneous coronary intervention complications, risks fluoroscopy

Full Text

The Full Text of this article is available as a PDF (69.8 KB).

References

  • 1. Thompson RC, Cullom SJ: Issues regarding radiation dosage of cardiac nuclear and radiography procedures. J Nucl Cardiol 2006; 13: 19–23. [DOI] [PubMed] [Google Scholar]
  • 2. Coles DR, Smail MA, Negus IS, Wilde P, Oberhoff M, et al.: Comparison of radiation doses from multisclice computed tomography coronary angiography and conventional diagnostic angiography. J Am Coll Cardiol 2006; 47: 1840–1845. [DOI] [PubMed] [Google Scholar]
  • 3. Katritsis D, Efstathopoulos E, Betsou S, Korovesis S, Faulkner K, et al.: Radiation exposure of patients and coronary arteries in the stent era: a prospective study. Catheter Cardiovasc Interv 2000; 51: 259–264. [DOI] [PubMed] [Google Scholar]
  • 4. National Research Council of the National Academies : Board on Radiation Effects Research–Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation. Health Risks From Exposure to Low Levels of Ionizing Radiation. BEIR VII Phase 2. Washington, DC: The National Academies Press; 2005. [PubMed] [Google Scholar]
  • 5. United States Food and Drug Administration : Public Health Advisory. Avoidance of Serious x‐ray Induced Skin Injuries to Patients During Fluoroscopically‐Guided Procedures. Rockville, MD: Center for Devices and Radiological Health, United States Food and Drug Administration; 1994. [Google Scholar]
  • 6. Koenig TR, Wolff D, Mettler FA, Wagner LK: Skin injuries from fluoroscopically guided procedures, part 1: characteristics of radiation injury. Am J Roentgenol 2001; 177: 3–11. [DOI] [PubMed] [Google Scholar]
  • 7. Koenig TR, Mettler FA, Wagner LK: Skin injuries from fluoroscopically guided procedures, Part 2; Review of 73 cases and recommendations for minimizing dose delivered to patient. Am J Roentgenol 2001; 177: 13–20. [DOI] [PubMed] [Google Scholar]
  • 8. Vlietstra RE, Wagner LK, Koenig T, Mettler F: Radiation burns as a severe complication of fluoroscopically guided cardiological interventions. J Interv Cardiol 2004; 17: 131–142. [DOI] [PubMed] [Google Scholar]
  • 9. Hirshfeld JW Jr, Balter S, Brinker JA, Kern MJ, Klein LW, et al: ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. Circulation 2005; 111: 511–532. [DOI] [PubMed] [Google Scholar]
  • 10. Miller DL, Balter S, Noonan PT, Georgia JD: Minimizing radiation‐induced skin injury in interventional radiology procedures. Radiology 2002; 225: 329–336. [DOI] [PubMed] [Google Scholar]
  • 11. Hwang E, Gaxiola E, Vlietstra RE, Brenner A, Ebersole D, et al.: Real‐time measurement of skin radiation during cardiac catheterization. Cathet Cardiovasc Diagn 1998; 43: 367–370. [DOI] [PubMed] [Google Scholar]
  • 12. United States Food and Drug Administration : Center for Devices and Radiological Health MAUDE database: Adverse Event, reported 10/04/2006.
  • 13. Trianni A, Bernardi G, Padovani R: Are new technologies always reducing patient doses in cardiac procedures? Radiat Prot Dosimetry 2005; 117: 97–101. [DOI] [PubMed] [Google Scholar]
  • 14. Tsapaki V, Kottou S, Kollaros N, Dafnomili P, Koutelou M, et al.: Comparison of a conventional and a flat‐panel digital system in interventional cardiology procedures. Br J Radiol 2004; 77: 562–567. [DOI] [PubMed] [Google Scholar]

Articles from Clinical Cardiology are provided here courtesy of Wiley

RESOURCES