Peak skin dose in patients undergoing coronary intervention: a review

Abstract In the context of coronary intervention, studies describing the characteristics of the dosimetric measurements available to estimate skin dose were reviewed, and a comprehensive review was performed of articles that reported doses using the peak skin dose (Dskin,max). The effects of the different dose levels are already evident after 2 Gy and range from transient erythema to more severe manifestations, such as late dermal necrosis. Regarding the most appropriate dosimetric measurement to reflect the maximum dose received on a specific point of the skin, the Dskin,max stands out since it allows us to know the maximum dose received on an area of the skin. Furthermore, as an additional background, software associated with angiography systems has already appeared on the market that delivers, in real time, its value with 3D corporeal representations. The reported weighted Dskin,max values were 0.19, 0.79, and 1.46 Gy for coronary angiography, angioplasty, and angioplasty of total coronary occlusions, respectively; however, 2.2% of the reported procedures exceeded 3 Gy, a non-negligible figure considering the large number of procedures performed worldwide.