Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5

Comparison of a suspended radiation shielding system with a conventional apron and shielding in the cardiac catheterization laboratory.
V. Schweiger1, M. K. Cieslik1, V. L. Cammann1, M. Wuerdinger1, A. Candreva1, M. Gajic1, J. Michel1, P. Jakob1, J. Stehli1, B. Stähli1, A. Gotschy1, C. Templin1, für die Studiengruppe: InterTAK
1Universitäres Herzzentrum, UniversitätsSpital Zürich, Zürich, CH;

Background:
With an increasing number of procedures and indications for cardiac catheterizations, the importance of adequate protection from fluoroscopic scatter radiation has become highly relevant. Studies have shown that scattered radiation during catheterization can cumulatively promote the development of various diseases such as cataracts or brain tumors. In order to mitigate the received fluoroscopic scattered radiation, Suspended Radiation Protection Systems (SRPS) have been developed. They allow for great mobility during interventional procedures while providing strong protection from fluoroscopic scatter radiation. Another protective measurement that has recently been introduced is the Radpad, a sterile radiation protective drape. Thus, in this study, we aimed to investigate the Radpad and SRPS-initiated protection against fluoroscopic scatter radiation in the specific context of cardiac catheterization.

Methods:

125 cardiac catheterizations have been conducted at the University Hospital of Zurich. Exposure data were collected from a total of eleven interventionalists wearing the same four real-time dosimeters. All dosimeters were placed on the left side, one on the head at eye level, one on the mid-upper arm, one on the breast pocket, and one just above the ankle. Procedures were performed in the usual manner, with the primary operator positioned either at the femoral or the radial region. Additionally, the assistants wore two dosimeters, one placed on the head at eye level and one on the breast pocket. All primary operators wore either the classic gold-standard apron (skirt and vest) with an additional thyroid shield, or the SRPS. The reported data comprise operator exposure as indicated by the real-life dosimeters, as well as the fluoroscopy duration and the individual patient dose-area-product (DAP) as reported by the fluoroscopy unit. Operator exposure was standardized to the dose area product, as this reflects the truest depiction of the operator’s actual radiation exposure, independent of time and other factors such as habitual state.

Results:

The SRPS was able to reduce the overall SOE of protected areas (head, arm, chest) by 93,96% (p < 0.0001) compared to standard protective equipment consisting of one lead apron and multiple shields. However, the additional dosimeters worn at the ankles, which are typically unprotected in both groups, showed an insignificant increase of SOE by 53,19% (p = 0.5264) for interventionists wearing the SRPS compared to those wearing the standard protective gear. This could be observed in both elective (73% reduction, p = 0.0145) and acute (82.6% reduction, p = 0.0145) procedures. Interestingly, also the Radpad was able to reduce the SOE by 79,3% (p < 0.0001). As for the assistants, SRPS reduced SOE by 60.06% compared to CTR, however, here the p-value of 0.184 shows no significance, which is probably due to the yet small sample size in this analysis.

Conclusion:

Our results suggest that the SRPS and the Radpad reduce received fluoroscopic scatter radiation for the interventionalist and possibly for the assistant. Thus, compared to the gold standard, the SRPS represents a superior device for protection against fluoroscopic scatter radiation, particularly in the context of tasks and requirements of a protective system during cardiac interventions.


https://dgk.org/kongress_programme/jt2022/aP542.html