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Health Services Research & Development

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HSR&D Citation Abstract

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Panetta CJ, Galbraith EM, Yanavitski M, Koller PK, Shah B, Iqbal S, Cigarroa JE, Gordon G, Rao SV. Reduced radiation exposure in the cardiac catheterization laboratory with a novel vertical radiation shield. Catheterization and Cardiovascular Interventions : Official Journal of The Society For Cardiac Angiography & Interventions. 2020 Jan 1; 95(1):7-12.
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Abstract: OBJECTIVES: Investigation of novel vertical radiation shield (VRS) in reducing operator radiation exposure. BACKGROUND: Radiation exposure to the operator remains an occupational health hazard in the cardiac catheterization laboratory (CCL). METHODS: A mannequin simulating an operator was placed near a computational phantom, simulating a patient. Measurement of dose equivalent and Air Kerma located the angle with the highest radiation, followed by a common magnification (8 in.) and comparison of horizontal radiation absorbing pads (HRAP) with or without VRS with two different: CCL, phantoms, and dosimeters. Physician exposure was subsequently measured prospectively with or without VRS during clinical procedures. RESULTS: Dose equivalent and Air Kerma to the mannequin was highest at left anterior oblique (LAO)-caudal angle (p? < .005). Eight-inch magnification increased mGray by 86.5% and µSv/min by 12.2% compared to 10-in. (p? < .005). Moving 40?cm from the access site lowered µSv/min by 30% (p? < .005). With LAO-caudal angle and 8-in. magnification, VRS reduced µSv/min by 59%, (p? < .005) in one CCL and µSv by 100% (p = .016) in second CCL in addition to HRAP. Prospective study of 177 procedures with HRAP, found VRS lowered µSv by 41.9% (µSv: 15.2?±?13.4 vs. 26.2?±?31.4, p = .001) with no difference in mGray. The difference was significant after multivariate adjustment for specified variables (p? < .001). CONCLUSIONS: Operator radiation exposure is significantly reduced utilizing a novel VRS, HRAP, and distance from the X-ray tube, and consideration of lower magnification and avoiding LAO-caudal angles to lower radiation for both operator and patient.

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