Radiation exposure: Comparison of rapid exchange and conventional over‐the‐wire coronary angioplasty systems

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Abstract
The growth of coronary angioplasty has resulted in increased fluoroscopy time to patients, staff, and physicians. Rapid exchange‐type catheters have purported to reduce fluoroscopy time and procedure time compared to conventional over‐the‐wire systems. Of 150 consecutive patients, 54 were treated solely with rapid‐exchange catheters and 84 were treated solely with over‐the‐wire catheters. Excluding 12 cases treated with fixed wire or combination catheters, the following data were found: Overall procedural success was obtained in 98.5% (136/138) of patients, 1.5% (2) requiring emergency coronary artery bypass graft surgery. A significant 35% reduction in fluoroscopy time and 13% reduction in procedure time were found when rapid‐exchange catheters were used, with identical success rates, number of balloons used per case, and complication rates compared to over‐the‐wire catheters. Rapid‐exchange catheters should be considered as part of an overall effort to reduce radiation exposure in the interventional cardiology laboratory.