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Huet C, Dabin J, Domienik-Andrzejewska J, Hebre A, Honorio da Silva E, Lombardo P, Tamborino G, Vanhavere F. Effectiveness of staff radiation protection devices for interventional cardiology procedures. Phys Med 2023; 107:102543. [PMID: 36780792 DOI: 10.1016/j.ejmp.2023.102543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 01/13/2023] [Accepted: 02/03/2023] [Indexed: 02/13/2023] Open
Abstract
PURPOSE To evaluate the effectiveness of currently available radioprotective (RP) devices in reducing the dose to interventional cardiology staff, especially to the eye lens and brain. METHODS The performances of five RP devices (masks, caps, patient drapes, staff lead and lead-free aprons and Zero-Gravity (ZG) suspended radiation protection system) were assessed by means of Monte Carlo (MC) simulations. A geometry representative of an interventional cardiology setup was modelled and several configurations, including beam projections and staff distance from the source, were investigated. In addition, measurements on phantoms were performed for masks and drapes. RESULTS An average dose reduction of 65% and 25% to the eyes and the brain respectively was obtained for the masks by MC simulations but a strong influence of the design was observed. The cap effectiveness for the brain ranges on average between 13% and 37%. Nevertheless, it was shown that only some upper parts of the brain were protected. There was no significant difference between the effectiveness of lead and lead-free aprons. Of all the devices, the ZG system offered the highest protection to the brain and eye lens and a protection level comparable to the apron for the organs normally covered. CONCLUSION All investigated devices showed potential for dose reduction to specific organs. However, for masks, caps and drapes, it strongly depends on the design, exposure conditions and staff position. Therefore, for a clinical use, it is recommended to evaluate their effectiveness in the planned conditions of use.
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Affiliation(s)
- Christelle Huet
- Institut de radioprotection et de sûreté nucléaire, Pôle santé et environnement, Service de recherche en dosimétrie, Fontenay-aux-Roses, France.
| | - Jérémie Dabin
- Belgian Nuclear Research Centre, Research in Dosimetric Applications, Mol, Belgium
| | | | - Alexandre Hebre
- Institut de radioprotection et de sûreté nucléaire, Pôle santé et environnement, Service de recherche en dosimétrie, Fontenay-aux-Roses, France
| | | | - Pasquale Lombardo
- Belgian Nuclear Research Centre, Research in Dosimetric Applications, Mol, Belgium
| | - Giulia Tamborino
- Belgian Nuclear Research Centre, Research in Dosimetric Applications, Mol, Belgium
| | - Filip Vanhavere
- Belgian Nuclear Research Centre, Research in Dosimetric Applications, Mol, Belgium
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2
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Cammann VL, Schweiger V, Cieslik M, Seifert B, Gilhofer T, Koleva I, Würdinger M, Candreva A, Gajic M, Michel J, Jakob P, Stehli J, Stähli B, Templin C, Gotschy A. Effectiveness of radiation protection systems in the cardiac catheterization laboratory: a comparative study. Clin Res Cardiol 2023; 112:605-613. [PMID: 36646858 PMCID: PMC10160176 DOI: 10.1007/s00392-022-02142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/19/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND As numbers and complexity of percutaneous coronary interventions are constantly increasing, optimal radiation protection is required to ensure operator safety. Suspended radiation protection systems (SRPS) and protective scatter-radiation absorbing drapes (PAD) are novel methods to mitigate fluoroscopic scattered radiation exposure. The aim of the study was to investigate the effectiveness regarding radiation protection of a SRPS and a PAD in comparison with conventional protection. METHODS A total of 229 cardiac catheterization procedures with SRPS (N = 73), PAD (N = 82) and standard radiation protection (N = 74) were prospectively included. Real-time dosimeter data were collected from the first operator and the assistant. Endpoints were the cumulative operator exposure relative to the dose area product [standardized operator exposure (SOE)] for the first operator and the assistant. RESULTS For the first operator, the SRPS and the PAD significantly decreased the overall SOE compared to conventional shielding by 93.9% and 66.4%, respectively (P < 0.001). The protective effect of the SRPS was significantly higher compared to the PAD (P < 0.001). For the assistant, the SRPS and the PAD provided a not statistically significant reduction compared to conventional shielding in the overall SOE by 38.0% and 30.6%, respectively. CONCLUSIONS The SRPS and the PAD enhance radiation protection significantly compared to conventional protection. In most clinical scenarios, the protective effect of SRPS is significantly higher than the additional protection provided by the PAD. Comparison of the additional radiation protection provided by protective scatter-radiation absorbing drapes (PAD) and the suspended radiation protection system (SRPS) system over standard protection with lead aprons.
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Affiliation(s)
- Victoria L Cammann
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Victor Schweiger
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Maciej Cieslik
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Burkhardt Seifert
- Division of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thomas Gilhofer
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Iva Koleva
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Michael Würdinger
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Alessandro Candreva
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland.,PolitoBIO Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Marko Gajic
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Jonathan Michel
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Philipp Jakob
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Julia Stehli
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Barbara Stähli
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Christian Templin
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - Alexander Gotschy
- Department of Cardiology, University Hospital Zurich, University Heart Center, Raemistrasse 100, 8091, Zurich, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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3
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Sciahbasi A, Minardi S, Salvi N. Interventional cardiology and X-ray exposure of the head: do not forget to block scatter radiation. J Cardiovasc Med (Hagerstown) 2022; 23:821. [PMID: 36349947 DOI: 10.2459/jcm.0000000000001381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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4
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Loganovsky KM, Fedirko PA, Marazziti D, Kuts KV, Antypchuk KY, Perchuk IV, Babenko TF, Loganovska TK, Kolosynska OO, Kreinis GY, Masiuk SV, Zdorenko LL, Zdanevich NA, Garkava NA, Dorichevska RY, Vasilenko ZL, Kravchenko VI, Drosdova NV, Yefimova YV, Malinyak AV. BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT: PART II - RADIATION CEREBRO/OPHTALMIC EFFECTS IN CHILDREN, PERSONS EXPOSED IN UTERO, ASTRONAUTS AND INTERVENTIONAL RADIOLOGISTS. PROBLEMY RADIATSIINOI MEDYTSYNY TA RADIOBIOLOHII 2021; 26:57-97. [PMID: 34965543 DOI: 10.33145/2304-8336-2021-26-57-97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ionizing radiation (IR) can affect the brain and the visual organ even at low doses, while provoking cognitive, emotional, behavioral, and visual disorders. We proposed to consider the brain and the visual organ as potential targets for the influence of IR with the definition of cerebro-ophthalmic relationships as the «eye-brain axis». OBJECTIVE The present work is a narrative review of current experimental, epidemiological and clinical data on radiation cerebro-ophthalmic effects in children, individuals exposed in utero, astronauts and interventional radiologists. MATERIALS AND METHODS The review was performed according to PRISMA guidelines by searching the abstract and scientometric databases PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, published from 1998 to 2021, as well as the results of manual search of peer-reviewed publications. RESULTS Epidemiological data on the effects of low doses of IR on neurodevelopment are quite contradictory, while data on clinical, neuropsychological and neurophysiological on cognitive and cerebral disorders, especially in the left, dominant hemisphere of the brain, are nore consistent. Cataracts (congenital - after in utero irradiation) and retinal angiopathy are more common in prenatally-exposed people and children. Astronauts, who carry out longterm space missions outside the protection of the Earth's magnetosphere, will be exposed to galactic cosmic radiation (heavy ions, protons), which leads to cerebro-ophthalmic disorders, primarily cognitive and behavioral disorders and cataracts. Interventional radiologists are a special risk group for cerebro-ophthalmic pathology - cognitivedeficits, mainly due to dysfunction of the dominant and more radiosensitive left hemisphere of the brain, andcataracts, as well as early atherosclerosis and accelerated aging. CONCLUSIONS Results of current studies indicate the high radiosensitivity of the brain and eye in different contingents of irradiated persons. Further research is needed to clarify the nature of cerebro-ophthalmic disorders in different exposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.
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Affiliation(s)
- K M Loganovsky
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - P A Fedirko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - D Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100, Pisa, Italy
| | - K V Kuts
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - K Yu Antypchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - I V Perchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - T F Babenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - T K Loganovska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - O O Kolosynska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - G Yu Kreinis
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - S V Masiuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - L L Zdorenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - N A Zdanevich
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - N A Garkava
- State Institution «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», 9 Vernadsky Str., Dnipro, 49044, Ukraine
| | - R Yu Dorichevska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - Z L Vasilenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - V I Kravchenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - N V Drosdova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - Yu V Yefimova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - A V Malinyak
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
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5
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Yokota J, Kuratani T, Shimamura K, Shijo T, Yamashita K, Ide T, Matsumoto R, Miyagawa S. Impact of radiation to the eye of operators during endo-cardiovascular surgery and the importance of protection. Gen Thorac Cardiovasc Surg 2021; 70:347-351. [PMID: 34524630 DOI: 10.1007/s11748-021-01701-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To verify the amount of radiation exposure to the eye of operators during endocardiovascular surgery (ECVS) in hybrid operating room (HOR), which increases the risk of cataracts in surgeons. METHODS Fifty cases of ECVS (including 36 transcatheter aortic valve implantation and 14 thoracic endovascular repair) using the transfemoral approach performed from February 2020 to July 2020 were included. A measurement device was attached to the left side of the head of the operators and their assistants to measure the cumulative dose (CD) of intraoperative radiation exposure. The subjects were divided into the control group (Group C, n = 26), received conventional protection using the protective curtain in HOR and the protected group (Group R, n = 24), received conventional protection and protection sheet. The normalized CD by dose area product (CD/DAP) was evaluated. RESULTS The CD/DAP of the surgeons was significantly decreased in Group R, averaging at 5.97 μSV/Gy cm2 in Group C group and 4.40 μSV/Gy cm2 in Group R (p < 0.01). Moreover, CD/DAP of the assistant was significantly reduced in the Group R, with an average of 1.87 μSV/Gy cm2 in the Group C and 1.01 μSV/Gy cm2 in Group R (p < 0.01). CONCLUSIONS The radiation exposure to the surgeon's eye could be significantly reduced by protection sheet.
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Affiliation(s)
- Junki Yokota
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan
| | - Toru Kuratani
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan.
| | - Kazuo Shimamura
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan
| | - Takayuki Shijo
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan
| | - Kizuku Yamashita
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan
| | - Toru Ide
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan
| | - Ryota Matsumoto
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan
| | - Shigeru Miyagawa
- Department of Cardiovascular Surgery, Osaka University, Yamada-Oka 2-2, Suita, Osaka, Japan
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6
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Zanca F, Dabin J, Collard C, Alexandre N, De Groote A, Salembier JP, Henry M, Rombaut E, Sghaier S, Massart PE. Evaluation of a suspended radiation protection system to reduce operator exposure in cardiology interventional procedures. Catheter Cardiovasc Interv 2021; 98:E687-E694. [PMID: 34347935 DOI: 10.1002/ccd.29894] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/02/2021] [Accepted: 07/10/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To investigate a novel suspended radiation shield (ZG), in reducing operator radiation exposure during cardiology interventions. BACKGROUND Radiation exposure to the operator remains an occupational health hazard in the cardiac catheterization laboratory. METHODS An anthropomorphic mannequin simulating an operator was placed near a phantom, simulating a patient. To measure the operator dose reduction, thermoluminescent detectors (TLDs) were inserted into the head and into the eye bulbs of the mannequin, while electronic dosimeters were positioned on the temple and at the level of the thyroid. Measurements were performed without and with the ZG system in place. Physician exposure was subsequently prospectively measured on the torso, on the left eye and on upper arm using the same electronic dosimeters, during clinical procedures (coronary angiography (CA) and percutaneous coronary intervention (PCI)). The physicians dose reduction was assessed by comparing operator dose when using traditional radioprotection garments (Phase 0) versus using the ZG system (Phase 1). RESULTS Dose reductions as measured on the mannequin ranged from 66% to the head, to 100% to the torso. No dose was detected at the level of the torso and thyroid with ZG. When comparing CA and PCI procedures between Phase 0 and Phase 1, a significant difference (p < 0.001) was found for the left eye and the left wrist. Dose reduction as measured during clinical procedures for left eye/upper arm were on average 78.9%/95.6% for CA and 83.0%/93.0% for PCI, respectively (p < 0.001 for both). CONCLUSIONS The ZG systems has a great potential to significantly reduce operator dose through the creation of a nearly zero-radiation work environment.
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Affiliation(s)
| | - Jérémie Dabin
- Research in Dosimetric Applications, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
| | - Celine Collard
- CHU UCL Namur site Sainte Elisabeth, Department of Cardiology, Namur, Belgium
| | | | | | - Jean Paul Salembier
- CHU UCL Namur site Sainte Elisabeth, Department of Cardiology, Namur, Belgium
| | - Michel Henry
- CHU UCL Namur site Sainte Elisabeth, Department of Cardiology, Namur, Belgium
| | - Emmanuel Rombaut
- CHU UCL Namur site Sainte Elisabeth, Department of Cardiology, Namur, Belgium
| | - Sonia Sghaier
- CHU UCL Namur site Sainte Elisabeth, Department of Cardiology, Namur, Belgium
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7
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Vano E, Rm SC, Jm FS. Helping to know if you are properly protected while working in interventional cardiology. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:1273-1285. [PMID: 33080586 DOI: 10.1088/1361-6498/abc325] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
Occupational protection is still a challenge for interventional cardiology. One of the main problems is the occasional improper use of the ceiling suspended screen. We present a methodology to audit the correct use of the shielding using active electronic dosimeters. To improve the protection, we suggest the use of an alert based on the ratio between the occupational dose per procedure, measured by a personal electronic dosimeter over the lead apron, and the dose measured by an unshielded dosimeter, located at the C-arm. The new electronic dosimeters and the automatic dose management systems allow processing the dosimetric data for individual procedures and for the radiation events, sending the values (wireless) to a central database. We selected six interventional cardiologists and analysed 385 interventional procedures involving about 30 000 radiation events. Our results suggest that for individual procedures, standard values of the ratio between operator dose and the C-arm reference dose, should be between 1%-2% for a proper use of the shielding. Percentage values ≥5%-10% for individual procedures, require an analysis of the different radiation events to identify the lack of occupational protection and suggest corrective actions. In our sample, half of the operators should improve the use of the shielding in around 20% of the procedures. Using this ratio as an alert to operators allows optimising occupational radiation protection and discriminating between high occupational doses derived from complex procedures and high doses due to the improper use of the protective screen.
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Affiliation(s)
- E Vano
- Radiology Department, Faculty of Medicine. Complutense University, E-28040 Madrid, Spain
- IdISSC and Medical Physics Service, Hospital Clínico San Carlos, Martin Lagos s.n., E-28040 Madrid, Spain
| | - Sanchez Casanueva Rm
- Radiology Department, Faculty of Medicine. Complutense University, E-28040 Madrid, Spain
- IdISSC and Medical Physics Service, Hospital Clínico San Carlos, Martin Lagos s.n., E-28040 Madrid, Spain
| | - Fernandez Soto Jm
- IdISSC and Medical Physics Service, Hospital Clínico San Carlos, Martin Lagos s.n., E-28040 Madrid, Spain
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8
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McCutcheon K, Vanhaverbeke M, Pauwels R, Dabin J, Schoonjans W, Bennett J, Adriaenssens T, Dubois C, Sinnaeve P, Desmet W. Efficacy of MAVIG X-Ray Protective Drapes in Reducing Operator Radiation Dose in the Cardiac Catheterization Laboratory: A Randomized Controlled Trial. Circ Cardiovasc Interv 2020; 13:e009627. [PMID: 33092401 DOI: 10.1161/circinterventions.120.009627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Interventional cardiologists are occupationally exposed to high doses of ionizing radiation. The MAVIG X-ray protective drape (MXPD) is a commercially available light weight, lead-free shield placed over the pelvic area of patients to minimize operator radiation dose. The aim of this study was to examine the efficacy of the MXPD during routine cardiac catheterization, including percutaneous coronary interventions. METHODS We performed a prospective, randomized controlled study comparing operator radiation dose during cardiac catheterization and percutaneous coronary intervention (n=632) with or without pelvic MXPD. We measured operator radiation dose at 4 sites: left eye, chest, left ring finger, and right ring finger. The primary outcomes were the difference in first operator radiation dose (µSv) and relative dose of the first operator (radiation dose normalized for dose area product) at the level of the chest in the 2 groups. RESULTS The use of the MXPD was associated with a 50% reduction in operator radiation dose (median dose 30.5 [interquartile range, 23.0-39.7] µSv in no drape group versus 15.3 [interquartile range, 11.1-20.0] µSv in the drape group; P<0.001) and a 57% reduction in relative operator dose (P<0.001). The largest absolute reduction in dose was observed at the left finger (median left finger dose for the no drape group was 104.9 [75.7-137.4] µSv versus 41.9 [32.6-70.6] µSv in the drape group; P<0.001). CONCLUSIONS The pelvic MXPD significantly reduces first operator radiation dose during routine cardiac catheterization and percutaneous coronary intervention. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT04285944.
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Affiliation(s)
- Keir McCutcheon
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (K.M., M.V., R.P., J.B., T.A., C.D., P.S., W.D.).,Department of Cardiovascular Sciences, Katholieke Universiteit, Leuven, Belgium (K.M., J.B., T.A., C.D., P.S., W.D.)
| | - Maarten Vanhaverbeke
- Belgian Nuclear Research Centre, Research in Dosimetric Applications, Mol, Belgium (J.D., W.S.)
| | - Ruben Pauwels
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (K.M., M.V., R.P., J.B., T.A., C.D., P.S., W.D.)
| | - Jérémie Dabin
- Belgian Nuclear Research Centre, Research in Dosimetric Applications, Mol, Belgium (J.D., W.S.)
| | - Werner Schoonjans
- Belgian Nuclear Research Centre, Research in Dosimetric Applications, Mol, Belgium (J.D., W.S.)
| | - Johan Bennett
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (K.M., M.V., R.P., J.B., T.A., C.D., P.S., W.D.).,Department of Cardiovascular Sciences, Katholieke Universiteit, Leuven, Belgium (K.M., J.B., T.A., C.D., P.S., W.D.)
| | - Tom Adriaenssens
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (K.M., M.V., R.P., J.B., T.A., C.D., P.S., W.D.).,Department of Cardiovascular Sciences, Katholieke Universiteit, Leuven, Belgium (K.M., J.B., T.A., C.D., P.S., W.D.)
| | - Christophe Dubois
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (K.M., M.V., R.P., J.B., T.A., C.D., P.S., W.D.).,Department of Cardiovascular Sciences, Katholieke Universiteit, Leuven, Belgium (K.M., J.B., T.A., C.D., P.S., W.D.)
| | - Peter Sinnaeve
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (K.M., M.V., R.P., J.B., T.A., C.D., P.S., W.D.).,Department of Cardiovascular Sciences, Katholieke Universiteit, Leuven, Belgium (K.M., J.B., T.A., C.D., P.S., W.D.)
| | - Walter Desmet
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium (K.M., M.V., R.P., J.B., T.A., C.D., P.S., W.D.).,Department of Cardiovascular Sciences, Katholieke Universiteit, Leuven, Belgium (K.M., J.B., T.A., C.D., P.S., W.D.)
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9
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Salinas P, Sanchez‐Casanueva RM, Gonzalo N, Gil J, Salazar CH, Jimenez‐Quevedo P, Nombela‐Franco L, Nuñez‐Gil I, Mejia‐Renteria H, Fernandez‐Soto JM, Fernandez‐Ortiz A, Vaño E, Escaned J. Dose‐reducing fluoroscopic system decreases patient but not occupational radiation exposure in chronic total occlusion intervention. Catheter Cardiovasc Interv 2020; 98:895-902. [DOI: 10.1002/ccd.29253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/04/2020] [Accepted: 08/06/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Pablo Salinas
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Roberto M. Sanchez‐Casanueva
- Medical Physics Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
- School of Medicine Universidad Complutense de Madrid Madrid Spain
| | - Nieves Gonzalo
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Jorge Gil
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Carlos H Salazar
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Pilar Jimenez‐Quevedo
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Luis Nombela‐Franco
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Ivan Nuñez‐Gil
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Hernan Mejia‐Renteria
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Jose M. Fernandez‐Soto
- Medical Physics Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
| | - Antonio Fernandez‐Ortiz
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
- School of Medicine Universidad Complutense de Madrid Madrid Spain
| | - Eliseo Vaño
- Medical Physics Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
- School of Medicine Universidad Complutense de Madrid Madrid Spain
| | - Javier Escaned
- Cardiology Department Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) Madrid Spain
- School of Medicine Universidad Complutense de Madrid Madrid Spain
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Aristizábal J. WITHDRAWN: Otra faceta de la evaluación del riesgo: la importancia de conocer el nuestro. REVISTA COLOMBIANA DE CARDIOLOGÍA 2019. [DOI: 10.1016/j.rccar.2018.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Byrne RA. The discovery of X-rays, the fate of atomic bomb survivors, and the impact on modern interventional cardiology. EUROINTERVENTION 2018; 14:129-131. [DOI: 10.4244/eijv14i2a18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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