Reduction in operator radiation exposure during transradial catheterization and intervention using a simple lead drape

• Published in: The American heart journal 2013-03, Vol.165 (3), p.293-298
• Main Authors: Iqtidar, Ali F., MD, Jeon, Cathy, MD, MSc, Rothman, Richard, MD, Snead, Randall, RRT, Pyne, Christopher T., MD
• Format: Article
• Language: English
• Subjects: Abdomen; Aged; Cardiac Catheterization - adverse effects; Cardiac Catheterization - methods; Cardiovascular; Female; Heart attacks; Humans; Intubation; Laboratories; Lead; Male; Middle Aged; Occupational Exposure - prevention & control; Personal protective equipment; Radial Artery - surgery; Radiation Dosage; Radiation Protection - methods; Radiography, Interventional - adverse effects; Radiography, Interventional - methods; Surgical Drapes; Veins & arteries
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2012.10.002

Background Transradial access for cardiac catheterization and intervention is a recognized method for reducing complications and improving patient comfort. However, there are concerns over possible increased operator radiation exposure. We tested the hypothesis that a simple lead drape would reduce operator exposure in transradial procedures. Methods Patients undergoing either diagnostic or interventional procedures using transradial access were assigned in an alternating manner to the use of a 0.5-mm lead apron across the patient's abdomen in addition to standard operator protection. Patients were divided into 4 groups: (left enhanced shielding vs left standard shielding; right enhanced shielding vs right standard shielding). Dosimeters were taped to the primary and secondary operators' left wrist and outside the thyroid guard. The operator exposure was measured for each site on every case in centigray. Results In standard shielded patients, there was no increase in operator exposure between the left and right approach patients at any measurement site. Measured exposure was reduced with enhanced shielding at all dosimeter sites except the secondary operator's collar (both left and right) and the primary operator's collar from the right. There was no significant difference in fluoroscopy, air kerma, or dose area product between standard and enhanced shielded patients. Conclusions The use of a lead drape reduces the rate of operator radiation exposure at multiple measurement sites. Use of the left radial approach was not associated with an increase in operator exposure compared with the right radial approach.