UN nuclear watchdog warns of radiation risk of angioplasty

Radiation from a common medical procedure known as angioplasty and other interventional heart procedures can cause relatively rare but severe and painful injuries and increase the probability of radiation-induced cancer, especially in small children, the United Nations nuclear watchdog warned today.

“Most cardiologists have no idea the procedures they perform can cause severe and extremely painful radiation injuries,” Professor of Radiological Physics at the University of Texas Louis Wagner told a two-day meeting at the International Atomic Energy Agency (IAEA) headquarters in Vienna.

“If a severe radiation burn is caused, more often than not it is then misdiagnosed,” Dr. Wagner said. “A gut-wrenching guess is about one patient per 10,000 receives a severe radiation injury.”

Cardiologists from 25 countries attending the meeting ending today were briefed by experts about simple but very effective ways to help prevent, recognize and treat radiation burns, among them ensuring that unnecessary body parts, such as a patient’s arm or breast, are not inadvertently exposed to the X-ray beam.

Doctors use angioplasty instead of open-heart surgery to unblock clogged arteries; the procedure involves passing a catheter through the blood vessel to open the blocked artery under fluoroscopic guidance using X-rays.

Historically cardiologists have not been trained in radiation protection, and as accessibility to the technology has increased, so has the chances of erythema, or radiation burns from the X-rays used, IAEA Radiation Safety Specialist Madan Rehani said.

Depending on the severity of the radiation dose, hair loss could occur or the rash can develop into a painfully sore ulcer, which requires surgical intervention such as skin grafts. “There is also a definite increase in the probability of radiation-induced cancer particularly when such procedures are performed on small children,” Dr. Rehani said.

“It is important doctors recognize the symptoms of an X-ray injury,” Dr. Wagner added. Usually a rash will appear a few days or weeks at the exact spot where the X-Ray beam was most directed. “There have been many cases where a patient is told to apply a cream or that it is only an allergic reaction. Doctors are confused and befuddled because the progression of an X-ray injury is not understood,” he said.