Increasing use and complexity of interventional fluoroscopy
In 2002, an estimated 657,000 percutaneous transluminal coronary angioplasty (PTCA) procedures were performed in adults in the United States. In addition, the rate of coronary artery stent insertion doubled from 157 to 318 per 100,000 adults, aged 45-64, from 1996 to 2000 (CDC 2004). At the same time, the complexity of interventional fluoroscopy has been increasing rapidly. This is due to the development of new devices and procedures, such as endografts for the treatment of abdominal aortic aneurysms, the development of vertebroplasty, kyphoplasty and uterine artery embolization, and increasing use of fluoroscopic guidance during complex endoscopic biliary and upper urinary tract procedures. As the complexity of these procedures has increased, the dose to patients and health care personnel has increased as well.