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Reduction in operator radiation exposure during transradial coronary procedures
using a simple lead rectangle
#MMPMID28280789
Osherov AB
; Bruoha S
; Laish Farkash A
; Paul G
; Orlov I
; Katz A
; Jafari J
Heliyon
2017[Feb]; 3
(2
): e00254
PMID28280789
show ga
OBJECTIVES: Transradial access for percutaneous coronary intervention (PCI)
reduces procedural complications however, there are concerns regarding the
potential for increased exposure to ionizing radiation to the primary operator.
We evaluated the efficacy of a lead-attenuator in reducing radiation exposure
during transradial PCI. METHODS AND RESULTS: This was a non-randomized,
prospective, observational study in which 52 consecutive patients were assigned
to either standard operator protection (n = 26) or the addition of the lead
attenuator across their abdomen/pelvis (n = 26). In the attenuator group patients
were relatively older with a higher prevalence of peripheral vascular disease
(67.9 vs 58.7 p = 0.0292 and 12% vs 7.6% p < 0.001 respectively). Despite similar
average fluoroscopy times (12.3 ± 9.8 min vs. 9.3 ± 5.4 min, p = 0.175) and
average examination doses (111866 ± 80790 vs. 91,268 ± 47916 Gycm(2), p =
0.2688), the total radiation exposure to the operator, at the thyroid level, was
significantly lower when the lead-attenuator was utilized (20.2% p < 0.0001) as
compared to the control group. Amongst the 26 patients assigned to the
lead-attenuator, there was a significant reduction in measured radiation of 94.5%
(p < 0.0001), above as compared to underneath the lead attenuator. CONCLUSIONS:
Additional protection with the use of a lead rectangle-attenuator significantly
lowered radiation exposure to the primary operator, which may confer long-term
benefits in reducing radiation-induced injury. ADVANCES IN KNOWLEDGE: This is the
first paper to show that a simple lead attenuator almost completely reduced the
scattered radiation at very close proximity to the patient and should be
considered as part of the standard equipment within catheterization laboratories.