The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

RAdiation exposure in Monoplane versus Biplane percutaneous cOronary angiography and interventions: The RAMBO Trial

DOI: 10.4244/EIJ-D-20-00217

1. Department of Cardiology, Charité Berlin – University Medicine, Campus Benjamin Franklin, Berlin; and DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
2. Department of Cardiology, Charité Berlin – University Medicine, Campus Benjamin Franklin, Berlin; and DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
3. German Rheumatism Research Center Berlin; and Institute for Epidemiology and Health Care Economics, Charité Berlin – University Medicine, Campus Mitte, Berlin, Germany
4. Department of Cardiology, Charité Berlin - University Medicine, Campus Benjamin Franklin, Berlin; and DZHK (German Centre for Cardiovascular Research) partner site Berlin, Berlin, Germany; Department of Cardiology, University Heart Centre, University Hospital Zurich, Zurich, Switzerland, Switzerland
Disclaimer:

As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received. The content of this article is the sole responsibility of the authors, and not that of the journal or its publishers.

Please note that supplementary movies are not available online at this stage. Once a paper is published in its edited and formatted form, it will be accompanied online by any supplementary movies.

To read the full content of this article, please log in to download the PDF.

Aims: Interventional cardiologists are exposed to substantial occupational ionizing radiation. This study sought to investigate differences in radiation exposure in biplane versus monoplane coronary angiography and percutaneous coronary interventions (PCI). 

Methods and Results: RAMBO (RAdiation exposure in Monoplane versus Biplane cOronary angiography and interventions) was a prospective, randomized, two-arm, single-centre, open-labelled trial, enrolling a total of 430 patients undergoing coronary angiography. Patients were randomly assigned to biplane or monoplane imaging. The primary efficacy measure, the operator radiation dose at the level of the left arm as measured by a wearable electronic dosimeter, was significantly higher in the biplane as compared with the monoplane group (4 [1-13] μSv versus 2 [0-6.8] μSv, p<0.001). The dose area product was 11955 [7095-18246] mGy*cm2 and 8349 [5851-14159] mGy*cm2 in the biplane and the monoplane groups (p<0.001). While fluoroscopy time did not differ among groups (p=0.89), the amount of contrast medium was lower with biplane as compared with monoplane imaging (p<0.001). 

Conclusions: Biplane imaging for coronary angiography and PCI is related with an increased radiation exposure to the interventional cardiologist as compared with monoplane imaging. Monoplane imaging should be considered for advanced radioprotection in cardiac catheterization, with biplane imaging used for selected cases.

Sign in to read and download the full article

Forgot your password?
No account yet? Sign up for free!
Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Read next article

Acute and One-year Clinical Outcomes of Pre-stenting Intravascular Ultrasound: A Patient-level Meta-analysis of Randomised Clinical Trials