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Reduced radiation exposure in the cardiac catheterization laboratory with a novel vertical radiation shield.

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 Sv/min by 12.2% compared to 10-in. (p < .005). Moving 40 cm from the access site lowered Sv/min by 30% (p < .005). With LAO-caudal angle and 8-in. magnification, VRS reduced Sv/min by 59%, (p < .005) in one CCL and Sv by 100% (p = .016) in second CCL in addition to HRAP. Prospective study of 177 procedures with HRAP, found VRS lowered Sv by 41.9% ( Sv: 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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