Efficacy of an Additional Mobile Leaded Shield on Operator Radiation During Percutaneous Coronary Angiography

Abstract

Operator radiation protection during percutaneous coronary angiography (CA) is a growing concern in the catheterisation laboratory (cath lab). The purpose of this study was to evaluate the efficacy of an additional mobile leaded shield on operator radiation exposure during diagnostic CA. The study involved two operators from the same cath lab and patients scheduled for diagnostic coronary catheterisation over a period of 2 months. Procedures were performed with standard radiation equipment during the first month. An additional mobile lead shield was added during the second month. Radiation exposure was measured by three dosimeters positioned on the operator's left hand, on their chest under the lead apron and on lead glasses. The intra-operator results were compared. Ninety-nine per cent of the procedures were carried out by radial access. For Operators 1 and 2, the mobile shield, respectively, decreased the radiation dose to the eyes by 43 and 33 % and to the hands by 61 and 83 %. Thorax dose was less than the minimum measurable dose (<0.01 mSv) for each operator. There was no significant difference in total procedure duration, fluoroscopy time or contrast dose required between the two groups of patients. Improved operator radiation protection is an important issue in the face of increased occupational doses. Mobile leaded shield, combined with standard preventive measures, seems to be an effective additional option to reduce the radiation exposure during diagnostic CA.

Extended Protective Shield Under Table to Reduce Operator Radiation Dose in Percutaneous Coronary Procedures

“…Moreover, and most important, the system is expensive and limits the free movement of the interventional cardiologist as for the other systems tested previously. 5,6,8 Our study has some limitations. First of all, the study lacks a sham control in group 1.…”

“…Operator dose at thorax level was also significantly lower in group 2 compared with group 1 even after normalization by DAP and AK (Table 2). Differently, there was only a trend to a reduction in radiation exposure at wrist level (3.8 µSv [1][2][3][4][5][6][7][8][9]…”

“…n recent years, among interventional cardiologists, the knowledge of deterministic 1 and stochastic 2 risks associated with their chronic exposure to radiographs has been increased. Many procedural advices (as the use of a reduction in radiographs pulse rate or the use of fluoro rather than cine mode acquisition) 3,4 or different protective devices (as the use of adjunctive protective drapes or dedicated protective boards and structures) [5][6][7][8] have been tested with a significant reduction in radiation exposure for the operator. In particular, the use of adjunctive protective drapes placed over the pelvic region of the patient is a simple and highly effective measure to reduce the operator radiation dose at thorax level with a reduction in dose ≤84%.…”

Assessment of occupational dose reduction with the use of a floor mounted mobile lead radiation protection shield

“…Floor mounted mobile shields are significantly larger and are most frequently used by circulating personnel who remain at greater distances from the patient during the procedure [10]. However, it is innovation in the design of non-operator supported devices, such as the RAMPART M1128 device, that has received significant interest, as these devices aim to provide substantial radiation protection to personnel in close proximity to the patient during radiation exposures [11][12][13].…”