This common procedure and others like it require constant monitoring with x-rays, which results in radiation exposure that is around a thousand times more than a standard chest x-ray.
“Most cardiologists have no idea the procedures they perform can cause severe and extremely painful radiation injuries,” Louis Wagner, professor of radiological physics at the University of Texas, told participants at the conference.
Four experts spoke to reporters about the problem, which they said could be solved by heightened awareness and training programs. They agreed it was surprising that many medical doctors were so naive about the dangers of radiation.
“It is shocking, but it is a fact,” said IAEA radiation safety specialist, Dr Madan Rehani. “X-rays have been used in this way safely for decades, so they think it’s safe.”
There are no worldwide statistics on the numbers of burns caused from this procedure but about one case per month is turning up in U.S. courts. The doctors gave a rough estimate of one severe burn in 10,000 procedures.
The doctors said there are around one million angioplasty procedures performed worldwide every year.
“It is reasonable to assume that these injuries are occurring in other parts of the world (outside the U.S.),” Rehani said, adding that many cases probably went unreported.
OBESITY INCREASES BURN RISK
Cardiologists prefer angioplasty over open-heart surgery to unblock clogged arteries in the heart, because it is a simple procedure and patients can leave the hospital the next day.
Rehani said radiation burns are most frequent in obese people because a higher-dose x-ray beam is required to monitor the patients.
Radiation burns usually begin as a rash that appears a few days or weeks at the spot where the x-ray was focused.
Depending on the severity of the radiation dose, hair loss could occur or the rash can develop into a painfully sore ulcer, which requires surgery and skin grafts.
“There is also a definite increase in the probability of radiation-induced cancer, particularly when such procedures are performed on small children,” Rehani said.
He said doctors can reduce the number of burns by screening patients to find out if they have had a recent angioplasty and if they are “radiologically sensitive.” During procedures, one should avoid focusing the x-ray on any spot for too long.
Finally, doctors need to recognize the symptoms of burns and ensure patients have proper follow-up examinations.
The doctors said nuclear applications in medicine are becoming increasingly common and account for over 90 percent of all the radioactive exposure people encounter.
Revision date: July 8, 2011
Last revised: by Jorge P. Ribeiro, MD