Reduced radiation exposure in the cardiac catheterization laboratory with a novel vertical radiation shield

Panetta, Carmelo; Galbraith, Erin M.; Yanavitski, Marat; Koller, Patrick K.; Shah, Binita; Iqbal, Sohah N.; Cigarroa, Joaquin E.; Gordon, Gregory; Rao, Sunil V.

doi:10.1002/ccd.28629

Cited by 9 publications

(3 citation statements)

References 26 publications

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“…Multiple randomized trials found less radiation with left versus right radial [45][46][47][48][49] although one trial found more radiation with left radial [50]. Avoiding steep angles, particularly LAO -Caudal, lower magnification, lower frame rate with fluoroscopy, and distance is recommended [51,52]. Further research comparing access sites is warranted to better understand with current technology the risks of radiation exposure.…”

Section: Areas Of Researchmentioning

confidence: 99%

Radial Artery Access

Panetta¹,

Chahine²

2021

Interventional Treatment for Structural Heart Disease

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Radial artery access for angiography has matured over the past two decades and is now the preferred point of access for most patients. Lower bleeding rates in clinical randomized trials have translated into lower mortality prompting change in the guidelines. Advances in technique with use of ultrasound for access to properly size the sheath, proper dosing of anticoagulation and new techniques for sheath removal have dramatically lowered radial artery occlusion rates. Radial artery spasm has improved with vasodilators and proper sedation. Advances in support boards and sheath extension have opened up left radial access. Advances in lower profile sheaths and sheathless systems allow larger catheters in smaller arteries. Advances in longer balloons and sheaths have opened up radial access for peripheral interventions. Areas of clinical research include use of ulnar artery compared to radial, left versus right radial access, use of radial artery for a surgical conduit after angiography, radiation exposure and advantage of radial approach in the elderly.

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Section: Areas Of Researchmentioning

confidence: 99%

Radial Artery Access

Panetta¹,

Chahine²

2021

Interventional Treatment for Structural Heart Disease

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“…These include avoiding left anterior oblique (LAO) and steep caudal/cranial angulation, greater distance from the X-ray tube, lead shielding, suspended protection systems, and vascular robotics. 6 X-ray generation occurs in an evacuated glass envelope containing a cathode filament and an anode. 7 The cathode filament is heated, and a high voltage is applied across the gap between the cathode and anode causing the cathode to emit electrons that release energy when they strike the anode.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Decreased Frame Rate During Cardiac Catheterization on Patient and Radiation Safety Outcomes

Oredegbe,

Derakhshesh,

Vuthoori

et al. 2023

Preprint

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ObjectiveCoronary artery disease (CAD) is an important cause of morbidity and mortality all over the world. Cardiac catheterization is one of the most important treatment modalities in managing CAD. Unfortunately, cardiac catheterization is associated with significant ionizing radiation exposure to both patients and personnel. This study aimed to compare the safety and efficacy of a lower video frame rate of 7.5-fps compared with the standard frame rate of 15-fps.Materials and MethodsWe retrospectively collected and reviewed data from 84 cardiac catheterizations performed between January and February 2020 at a single tertiary center. The patients were divided into two groups based on frame rate: 15-fps (n=42) and 7.5-fps (n=42). We compared the two groups in terms of demographic data, procedural characteristics, radiation dose, and patient outcomes.ResultsCumulative air kerma was significantly lower in the 7.5-fps group (266.576 mGy) compared to the 15-fps group (524.140 mGy), p=0.0018. Similarly, total dose area product was lower in the 7.5-fps group (15335.617 mGy × cm2compared to the 15-fps group (34784.095 mG × cm2), p = 0.0003. Despite this, total fluoroscopic time did not differ between the two groups 7.74 minutes in the 15-fps group and 8.462 minutes in the 7.5-fps group, p = 0.4023). In addition, 30-day mortality 0% in both groups and there were no differences in the number of repeat PCIs performed within 30 days (6 in 7.5-fps and 3 in the 15-fps group), p = 0.2899.ConclusionDuring cardiac catheterization, a fluoroscopy rate of 7.5-fps is associated with lower radiation dose compared to 15-fps without an associated increase in fluoroscopy time, mortality or repeat PCI. Therefore, interventionalists should consider using a fluoroscopy rate of 7.5-fps during cardiac catheterization.

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“…Barium sulfate (BaSO 4 ), bismuth, and tungsten are the most frequently used eco-friendly shielding materials [3]. Numerous studies have been conducted on the shielding performance and manufacturing process technology of these materials, and products using these materials are currently being used in medical institutions [4,5].…”

Section: Introductionmentioning

confidence: 99%

Preparation and Performance Evaluation of X-ray-Shielding Barium Sulfate Film for Medical Diagnosis Using PET Recycling and Multi-Carrier Principles

Kim

2022

Coatings

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The use of disposable containers and packaging materials has increased due to the recent COVID-19 pandemic. Thus, the generation of plastic waste is also increasing, and research on recycling such waste is being actively conducted. In this study, an X-ray-shielding film for medical diagnosis was manufactured by mixing a radiation-shielding material and a plastic waste-based polymer material and its effectiveness was evaluated. The film, which is intended as a fabric for a shielding garment, consists of barium sulfate (BaSO4) shielding nanoparticles embedded in a matrix of polyethylene terephthalate (PET), a commonly available waste plastic material. A particle-dispersing technology, which can improve the ratio between the shielding and matrix materials while maintaining the tensile strength of the film, was studied. Therefore, to increase the content of the barium sulfate (BaSO4) nanoparticles used as the shielding material, this multi-carrier method—under which the particles are dispersed in units of time—was developed to improve the shielding performance. Compared with the effectiveness of lead (Pb) shielding film, the 3 mm barium sulfate film developed in this study satisfies the lead equivalent of 0.150 mmPb when stacked in two layers. Therefore, a shielding film was successfully manufactured by using plastic waste as a polymer resin and barium sulfate, an eco-friendly radiation-shielding material, instead of lead.

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Reduced radiation exposure in the cardiac catheterization laboratory with a novel vertical radiation shield

Cited by 9 publications

References 26 publications

Radial Artery Access

Radial Artery Access

The Effects of Decreased Frame Rate During Cardiac Catheterization on Patient and Radiation Safety Outcomes

Preparation and Performance Evaluation of X-ray-Shielding Barium Sulfate Film for Medical Diagnosis Using PET Recycling and Multi-Carrier Principles

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