Performance of a Radiation Protection Cabin During Extraction of Cardiac Devices

• Published in: Canadian journal of cardiology 2014-12, Vol.30 (12), p.1602-1606
• Main Authors: Ploux, Sylvain, MD, Jesel, Laurence, MD, Eschalier, Romain, MD, PhD, Amraoui, Sana, MD, Ritter, Philippe, MD, Haïssaguerre, Michel, MD, Bordachar, Pierre, MD, PhD
• Format: Article
• Language: English
• Subjects: Cardiovascular; Device Removal - methods; Dose-Response Relationship, Radiation; Equipment Design; Female; Fluoroscopy - methods; Follow-Up Studies; Humans; Intraoperative Period; Male; Middle Aged; Occupational Exposure - prevention & control; Pacemaker, Artificial; Radiation Injuries - etiology; Radiation Injuries - prevention & control; Radiation Protection - instrumentation; Radiometry - methods
• ISSN: 0828-282X; 1916-7075
• DOI: 10.1016/j.cjca.2014.08.011

Abstract Background Operators who extract cardiac devices are exposed to considerable irradiation and excess risk of radiation-induced disorders. A dedicated radioprotection cabin was developed to offer complete protection against radiation. This randomized study was designed to ascertain the protection against radiation conferred by a radioprotection cabin and the safety during extraction of cardiac devices. Methods Thirty-seven consecutive patients who presented with an indication for extraction of a cardiac device were randomly assigned to a standard extraction technique (n = 19), vs extraction with the use of a radiation protection cabin (n = 18). Fluoroscopic exposure was compared using electronic dosimeters placed on the thorax, back, foot, and head of the operator. Results The procedural times and total fluoroscopic exposure times and the complication rates were not significantly different between the 2 groups. The mean dose of radiation delivered to the thorax and back was similar in both groups ( P  = 0.3 and P  = 0.8, respectively). In contrast, the mean doses of radiation delivered to the head and to the feet were respectively 68 and 390 times less in the cabin group than in the control group ( P < 0.001). Conclusions The cabin offers nearly full body radioprotection and eliminates the need to wear a lead apron, without increasing procedural time or complication rate during cardiac device extraction.