Impact of a disposable sterile radiation shield on operator radiation exposure during percutaneous coronary intervention of chronic total occlusions

Deborah Shorrock, Georgios Christopoulos, Jedrek Wosik, Anna Kotsia, Bavana Rangan, Shuaib Abdullah, Daisha Cipher, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background. Daily radiation exposure over many years can adversely impact the health of medical professionals. Methods. Operator radiation exposure was recorded for 124 percutaneous coronary interventions (PCIs) performed at our institution between August 2011 and May 2013: 69 were chronic total occlusion (CTO)-PCIs and 55 were non-CTO PCIs. A disposable radiation protection sterile drape (Radpad; Worldwide Innovations & Technologies, Inc) was used in all CTO-PCI cases vs none of the non-CTO PCI cases. Operator radiation exposure was compared between CTO and non-CTO PCIs. Results. Mean age was 64.6 ± 6.2 years and 99.2% of the patients were men. Compared with non-CTO PCI, patients undergoing CTO-PCI were more likely to have congestive heart failure, to be current smokers, and to have longer lesions, and less likely to have prior PCI and a saphenous vein graft target lesion. CTO-PCI cases had longer procedural time (median: 123 minutes (IQR, 85-192 minutes] vs 27 minutes [IQR, 20-44 minutes]; P<.001), fluoroscopy time (35 minutes [IQR, 19-54 minutes] vs 8 minutes [IQR, 5-16 minutes]; P<.001), number of stents placed (2.4 ± 1.5 vs 1.7 ± 0.9; P<.001), and patient air kerma radiation exposure (3.92 Gray [IQR, 2.48-5.86 Gray] vs 1.22 Gray [IQR, 0.74-1.90 Gray]; P<.001), as well as dose area product (267 Gray·cm2 [IQR, 163-4.25 Gray·cm2] vs 84 Gray·cm2 [IQR, 48-138 Gray·cm2]; P<.001). In spite of higher patient radiation exposure, operator radiation exposure was similar between the two groups (20 μSv [IQR, 9.5-31 μSv] vs 15 μSv [IQR, 7-23 μSv]; P=.07). Conclusions. Operator radiation exposure during CTO-PCI can be reduced to levels similar to less complicated cases with the use of a disposable sterile radiation protection shield.

Original languageEnglish (US)
Pages (from-to)313-316
Number of pages4
JournalJournal of Invasive Cardiology
Volume27
Issue number7
StatePublished - Jul 1 2015

Keywords

  • Chronic total occlusion
  • Percutaneous coronary intervention
  • Radiation exposure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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