Evidence map›Paper›PMID 38092365›Full record

ArticleJournal of cerebrovascular and endovascular neurosurgery2024

Reducing frame rate and pulse rate for routine diagnostic cerebral angiography: ALARA principles in practice.

Arvin R Wali, Sarath Pathuri, Michael G Brandel, Ryan W Sindewald, Brian R Hirshman, Javier A Bravo, Jeffrey A Steinberg, Scott E Olson, Jeffrey S Pannell, Alexander Khalessi and 1 more

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Article in Journal of cerebrovascular and endovascular neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Arvin R WaliDepartment of Neurosurgery, University of California San Diego, CA, USA.
Sarath PathuriLong School of Medicine, University of Texas Health Sciences Center at San Antonio, TX, USA.
Michael G BrandelDepartment of Neurosurgery, University of California San Diego, CA, USA.
Ryan W SindewaldDepartment of Neurosurgery, University of California San Diego, CA, USA.
Brian R HirshmanDepartment of Neurosurgery, University of California San Diego, CA, USA.
Javier A BravoDepartment of General Surgery, University of California San Diego, CA, USA.
Jeffrey A SteinbergDepartment of Neurosurgery, University of California San Diego, CA, USA.
Scott E OlsonDepartment of Neurosurgery, University of California San Diego, CA, USA.
Jeffrey S PannellDepartment of Neurosurgery, University of California San Diego, CA, USA.
Alexander KhalessiDepartment of Neurosurgery, University of California San Diego, CA, USA.
David Santiago-DieppaDepartment of Neurosurgery, University of California San Diego, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDiagnostic cerebral angiograms (DCAs) are widely used in neurosurgery due to their high sensitivity and specificity to diagnose and characterize pathology using ionizing radiation. Eliminating unnecessary radiation is critical to reduce risk to patients, providers, and health care staff. We investigated if reducing pulse and frame rates during routine DCAs would decrease radiation burden without compromising image quality.

methodsWe performed a retrospective review of prospectively acquired data after implementing a quality improvement protocol in which pulse rate and frame rate were reduced from 15 p/s to 7.5 p/s and 7.5 f/s to 4.0 f/s respectively. Radiation doses and exposures were calculated. Two endovascular neurosurgeons reviewed randomly selected angiograms of both doses and blindly assessed their quality.

resultsA total of 40 consecutive angiograms were retrospectively analyzed, 20 prior to the protocol change and 20 after. After the intervention, radiation dose, radiation per run, total exposure, and exposure per run were all significantly decreased even after adjustment for BMI (all p<0.05). On multivariable analysis, we identified a 46% decrease in total radiation dose and 39% decrease in exposure without compromising image quality or procedure time.

conclusionsWe demonstrated that for routine DCAs, pulse rate of 7.5 with a frame rate of 4.0 is sufficient to obtain diagnostic information without compromising image quality or elongating procedure time. In the interest of patient, provider, and health care staff safety, we strongly encourage all interventionalists to be cognizant of radiation usage to avoid unnecessary radiation exposure and consequential health risks.

Indexed as

ALARACerebral angiographyEndovascular proceduresFluoroscopyRadiation

Identifiers

PMID38092365
PMCPMC10995471

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.