Effectiveness of radiation protection systems in the cardiac catheterization laboratory: a comparative study

• DOI: 10.1007/s00392-022-02142-8
• Publication Date: 2023-01-16T17:02:58Z
• Authors: Victoria L. Cammann; Victor Schweiger; Maciej Cieslik; Burkhardt Seifert; Thomas Gilhofer; Iva Koleva; Michael Würdinger; Alessandro Candreva; Marko Gajic; Jonathan Michel; Philipp Jakob; Julia Stehli; Barbara Stähli; Christian Templin; Alexander Gotschy
• Keywords: Radiation protection; Original Paper; Cardiac Catheterization; Suspended radiation protection systems; 610 Medicine & health; Protective scatter-radiation absorbing drapes; Radiation Exposure; Radiation Dosage; Radiography, Interventional; 2705 Cardiology and Cardiovascular Medicine; 3. Good health; 03 medical and health sciences; Radiation Protection; 0302 clinical medicine; SRPS; Occupational Exposure; 10209 Clinic for Cardiology; Humans; Radiation protection; Suspended radiation protection systems; SRPS; Protective scatter-radiation absorbing drapes; RADPAD; Cardiac catheterization; Cardiac catheterization; RADPAD

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.

Graphical abstract