Enhanced radiation protection devices (ERPDs) reduce scatter radiation exposure for physicians, assistants and nurses in the cardiac catheterization laboratory, compared with standard shielding, a new study shows. These data were presented during a late-breaking clinical trials session on Tuesday, March 10, at Cardiovascular Research Technologies (CRT) 2026 in Washington, D.C. by Santiago Garcia, MD, of The Christ Hospital in Cincinnati, Ohio. H reported that when paired with these systems, lighter lead aprons and, in some cases, potentially no apron at all, may still keep exposure below recommended annual limits. “Radiation exposure in the cardiac catheterization laboratory (CCL) poses a significant occupational hazard to all members involved in the procedures,” Dr. Garcia said “Lead aprons, the most common form of radiation protection in clinical practice, are associated with orthopedic injuries and musculoskeletal pain.” Three shielding strategies The study enrolled a total of 135 patients (mean age 68 (±11), 73% male). The approach compared three shielding strategies during coronary angiography and percutaneous coronary intervention: standard shielding, the EggNest Protect ERPD and the EggNest Complete ERPD. The investigative team used real-time dosimetry to measure radiation exposure at three staff positions: primary operator, scrub/assistant and circulating nurse. For the primary operator, average ICRP 20 dose per case fell from 1.85 millirem (mRem) with standard shielding to 0.33 mRem with EggNest Protect and 0.16 mRem with EggNest Complete, a statistically significant difference across groups (p<0.001). For the assistant, the corresponding exposures were 0.21, 0.06 and 0.03 mRem per case, respectively; for the circulating nurse, they were 0.13, 0.02 and 0.03 mRem, again with significant differences across groups. Over-lead measurements Further findings, which focused on over-lead measurements, revealed that the median collar dose per case for the primary operator decreased from 0.29 mRem with standard shielding to 0.20 mRem with EggNest Protect and 0.09 mRem with EggNest Complete. Among assistants, collar dose dropped from 0.21 to 0.05 and 0.03 mRem, respectively, while for nurses it declined from 0.09 to 0.03 and 0.03 mRem. “Both ERPDs used in combination with light (0.125 mm) lead yielded lower effective doses when compared to standard shielding and standard (0.5 mm) lead,” Dr. Garcia noted. “These doses represented <1 % of the recommended ICRP annual limit assuming 300 similar cases per year.” Benefit to operators Total effective dose equivalent analyses indicated that operators, who face the highest cumulative radiation burden, would receive the greatest benefit. Annualized EDE-1 for the primary operator was 51.4 mRem with standard shielding, compared with 7.0 mRem using EggNest Protect and 2.4 mRem using EggNest Complete. In subgroup analyses, the Complete system paired with 0.125 mm lead yielded an annualized operator dose of 1.41 mRem, versus 51.4 mRem with standard shielding and standard lead. Dr. Garcia concluded that the addition of the Complete ERPD reduced scatter radiation to levels that could allow ultralight or no lead aprons under ALARA principles. This could be clinically meaningful in a field where chronic apron use has long been linked to musculoskeletal strain and orthopedic injury. Image Credit: Bailey G. Salimes, CRTonline.org Image Caption: Santiago Garcia, MD, of The Christ Hospital in Cincinnati, Ohio, presents his late-breaking clinical trial at Cardiovascular Research Technologies (CRT) 2026 in Washington, D.C.