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

    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*cm (10–35.5 Gy*cm ). 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, < 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, < 0.001, 1.7 μSv vs 0.49 μSv for II operator, < 0.001, 2.16 μSv vs 0.93 μSv for nurse circulator, = 0.02 and 0.85 μSv vs 0.39 μSv for technologist, = 0.01).

    Conclusions

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

    Highlights

     

    • All staff member performing percutaneous coronary procedures are chronically exposed to radiation
    • The operating physician receives the highest radiation dose followed by the nurse circulator
    • The use of protective drapes represents a simple and not expensive method to reduce radiation dose for all staff members.
    • The reduction in radiation dose ranged from 50-85% according to the staff member considered.

    Source:

    Cardiovascular Revascularization Medicine, 2018-10-01, Volume 19, Issue 7, Pages 755-758, Copyright © 2018 Elsevier Inc.

     

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