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. A lead attenuator was shown in preclinical studies to reduce operator radiation dose. This study sought to determine the efficacy of lead attenuator shielding for the reduction of operator radiation exposure.
Methods: Patients undergoing either diagnostic or interventional procedures using transradial access were assigned in a consecutive manner to the use of a 0.5-mm, 60X100 cm lead rectangle across the patient`s abdomen and pelvis from the umbilicus down, in addition to standard operator protection (Figure A and B). Dosimeters were taped to the patient’s umbilicus site underneath and over the lead rectangle and primary operator outside the thyroid guard. All data was normalized to the same Dose-Area Product (DAP). The operator exposure was measured for each site in mSievert (mSv).
Results: 52 consecutive patients undergoing coronary angiography and angioplasty by radial approach were recruited to pelvic attenuator use versus no radiation shield protection. (26 with attenuator, 26 control). Despite similar average fluoroscopy time (12.3 9.8 min vs. 9.3 5.4 min, P=0.175) and average procedural DAP (111866 80790 vs. 91,268 47916 Gycm2, P=0.2688), the mean total radiation exposure to the operator was significantly lower when pelvic attenuator was utilized. The neck dosimeters and umbilical level readings showed significant radiation dose reduction of 51.5%, p
Conclusions: A lead attenuator is a highly effective novel solution to reduce operator’s radiation exposure during radial procedures and should be regarded as a standard and mandatory tool in the catheterization laboratory.
