Staff radiation dose during percutaneous coronary procedures: Role of adjunctive protective drapes

Cardiovasc Revasc Med. 2018 Oct;19(7 Pt A):755-758. doi: 10.1016/j.carrev.2018.04.004. Epub 2018 Apr 6.

Abstract

Background: The use of adjunctive protective drapes placed on the patient protects the operating physician from scatter radiation during percutaneous coronary procedures (PCP). No data are available on the effect of these drapes for staff members' radio-protection.

Purpose: To evaluate staff radiation exposure during PCP and the effect of adjunctive protective drapes on dose reduction.

Methods: The RADIANT study (NCT01974453) is a prospective, observational study evaluating operator radiation exposure during PCP using electronic dosimeter. In a sub-group of procedures all the staff members (II operator, nurse circulator and technologist) were also equipped with a dedicated electronic dosimeter.

Results: From a total of 2028 procedures included in the RADIANT study, staff members' doses were available for 122 procedures (67 coronarography and 55 percutaneous coronary interventions). Median fluoroscopy time was 306 s (Interquartile range 155-526 s) and the dose area product (DAP) was 18.0 Gy*cm2 (10-35.5 Gy*cm2). The radiation exposure was highest for the operating physician (6.7 μSv) and progressively lower for the nurse circulator (1.8 μSv), the II operator (1 μSv) and the technologist (0.7 μSv, p < 0.001). Protective pelvic drapes were used in 43 procedures and associated with a lower radiation exposure for all staff members (14 μSv vs 2.2 μSv for operating physician, p < 0.001, 1.7 μSv vs 0.49 μSv for II operator, p < 0.001, 2.16 μSv vs 0.93 μSv for nurse circulator, p = 0.02 and 0.85 μSv vs 0.39 μSv for technologist, p = 0.01).

Conclusions: The use of adjunctive protective drapes is effective in reducing radiation protection for all staff members during PCP.

Keywords: Coronary procedures; PCI; Pelvic; Radiation dose; Transradial.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Health Personnel*
  • Humans
  • Male
  • Middle Aged
  • Nursing Staff
  • Occupational Exposure / adverse effects
  • Occupational Exposure / prevention & control*
  • Occupational Health*
  • Operating Room Technicians
  • Percutaneous Coronary Intervention* / adverse effects
  • Physicians
  • Prospective Studies
  • Protective Factors
  • Radiation Dosage*
  • Radiation Exposure / adverse effects
  • Radiation Exposure / prevention & control*
  • Radiation Protection / instrumentation*
  • Radiography, Interventional* / adverse effects
  • Risk Assessment
  • Risk Factors
  • Scattering, Radiation
  • Surgical Drapes*
  • Time Factors