Impact of Pelvic and Rad-Board Lead Shields on Operator and Patient Radiation Dose in Trans-Radial Coronary Procedures

Fard, Aida Khaleghi; Alian, Amir Hossein Mohammad; Pourafkari, Leili; Ghojazadeh, Morteza; Tarighatnia, Ali; Farajollahi, Alireza

doi:10.1093/rpd/ncz147

Cited by 5 publications

(2 citation statements)

References 32 publications

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“…Several solutions have been proposed. [5][6][7][8][9][10][11][12][13]17 In its simplest form, a nonsterile drape is placed on the patient under the surgical drape. 8 The obvious limitation of this approach is that the shield is not repositionable during the procedure and may conflict with the imaging area.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and User Experience of a Novel X-Ray Shield on Operator Radiation Exposure During Cardiac Catheterization: A Randomized Controlled Trial

Davidsen,

Ytre-Hauge,

Samnøy

et al. 2023

Circ: Cardiovascular Interventions

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Background: Radiation shielding is mandatory during cardiac catheterization, but there is a need to improve efficacy and ease of use. Methods: The aim of the study was to assess the shielding effect and user feedback for a novel flexible multiconfiguration x-ray shield (FMX). The 0.5-mm Pb equivalent FMX can be selectively configured to accommodate for variations in patient morphology, access site, and type of procedure with maintained visualization, vascular access, and shielding. To evaluate efficacy, relative operator dose (operator dose indexed for given dose) was measured during 103 consecutive procedures randomized in a 1:1 proportion to the current routine setup or FMX+routine. User feedback was collected on function, relevance, and likelihood of adoption into clinical practice. Results: Median relative operator dose was 3.63 μSv/µGy·m 2 ×10 –3 (IQR, 2.62–6.37) with routine setup and 0.57 μSv/µGy·m 2 ×10 –3 (IQR, 0.27–1.06) with FMX+routine, which amounts to an 84.4% reduction ( P <0.001). For 500 procedures/year, this corresponds to an estimated yearly dose reduction from 3.6 to 0.7 mSv. User feedback regarding size, functionality, ease of use, likely to use, critical issues, shielding, draping, procedure time, vascular access, patient discomfort, and risk was 99% positive. No critical issues were identified. There was no significant difference in patient radiation exposure. Conclusions: The FMX reduces radiation exposure considerably. The FMX represents an effective and attractive solution for radiation protection that can easily be implemented in existing workflow. FMX has potential for general use with maintained visualization, vascular access, and shielding in routine cardiac catheterization.

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Section: Discussionmentioning

confidence: 99%

Efficacy and User Experience of a Novel X-Ray Shield on Operator Radiation Exposure During Cardiac Catheterization: A Randomized Controlled Trial

Davidsen,

Ytre-Hauge,

Samnøy

et al. 2023

Circ: Cardiovascular Interventions

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“…Several studies have been conducted on the radiation exposure of operators (doctors, radiologists and nurses) and patients in cardiac catheterization [5][6][7][8]. According to Miller et al, the mean radiation exposure of a physician during cardiac catheterization at the eyes, thyroid glands, chest (inside the apron) and gonads is 20 mR, 2 mR-16 mR, 50 mR and 10 mR, respectively.…”

Section: Introductionmentioning

confidence: 99%

Radiation Dose Assessment of the Fog Lead Acrylic Shields during Coronary Angiography: A Phantom Study

et al. 2021

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This study aimed to evaluate the effects of fogging on the effectiveness of a lead glass shield in protecting an operator from radiation exposure during conventional coronary angiography (CAG). Optically stimulated luminescence dosimeters (OSLDs) were used to measure the effects of fogged lead glass shields (FLSs) and clear lead glass shields (CLSs) on the radiation doses of a cardiac catheterization surgeon. We simulated the scatter radiation incident on the operator with five angiographic projections with 10-s exposures. Experiments were conducted with a field of view of 25 cm, maximum of 100 cm between the X-ray tube and image intensifier, and 80 cm between the image intensifier and operator. Lead glass fogging had no significant effect at any angiographic projection. The average dose at the lens of the eye, thyroid glands, and gonads did not differ significantly between FLS and CLS. Although most surgeons view ceiling-suspended shields as hindrances during surgical procedures, the radiation dose at the operator’s eyes and thyroid glands increased by 13 and 10 times without the shield. The fogging of the shield is probably caused by post-surgery UV decontamination or detergents. An operator has no cause for concern regarding the radiation protection afforded by an FLS during CAG procedures.

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Operators’ radiation exposure reduction during cardiac catheterization using a removable shield

Arrivi

Pucci

Vaudo

et al. 2020

Cardiovasc Interv and Ther

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Impact of Pelvic and Rad-Board Lead Shields on Operator and Patient Radiation Dose in Trans-Radial Coronary Procedures

Cited by 5 publications

References 32 publications

Efficacy and User Experience of a Novel X-Ray Shield on Operator Radiation Exposure During Cardiac Catheterization: A Randomized Controlled Trial

Efficacy and User Experience of a Novel X-Ray Shield on Operator Radiation Exposure During Cardiac Catheterization: A Randomized Controlled Trial

Radiation Dose Assessment of the Fog Lead Acrylic Shields during Coronary Angiography: A Phantom Study

Operators’ radiation exposure reduction during cardiac catheterization using a removable shield

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