049 Marked reduction of operator radiation exposure by using a patient lead cover during coronary angiography or percutaneous intervention

Abstract

Operators and patient radiation exposure during interventional cardiology procedures may induce radiation injury and may increase risk of cancer. To determine the effectiveness of a lead cover placed over the patient abdomen and groins in reducing operator radiation exposure during coronary intervention. Radiation exposure measurements were performed over an 8 weeks period, in patients undergoing diagnostic and/or interventional coronary procedures. Usual protection of the operator was ensured using a lead apron, low leaded flaps, and leaded glass. Each of three procedures was realized using a lead cover placed on the patient abdomen. Operator irradiation was assessed by using 3 electronic dosimeters placed over the apron on the chest and in the back (no 1, 2) on the left arm (no 3). Patient radiation exposure (using the diamentor system), ambiental irradiation (using an electronic dosimeter placed in the room opposite to the Xray tube) and fluoroscopy times were recorded. Results are presented in mean ± SEM and comparisons assessed by student t test. Operator exposure was assessed during 189 procedures (136 coronary angiograms and 53 percutaneous coronary interventions) in 71 cases (37%) with the lead cover over the patient (group 1) and in 118 cases (63%) without it (group 2). Fluoroscopy times, dose area products and ambient irradiation were similar with and without the lead cover (4 ± 2 vs 4.1 ± 0.6 min, 55,7 ± 5,8 vs 57,6 ± 4,2 Gy cm 2 and 0.7 ± 0.2 vs 0.8 ± 0.1 μSv respectively – p > 0.05). However, operator irradiation was markedly decreased by using the lead cover: from 19.2 ± 3.1 to 4.9 ± 0.9 μSv at the chest level (p=0,001), from 1.8 ± 0.3 to 0.3 ± 0.1 μSv at the back (p=0.002) and from 25.8 ± 4.7 to 10.2 ± 2.2 μSv at the left arm (p=0,019). Using a lead cover placed over the patient is highly effective in attenuating operator scatter radiation exposure during coronary procedure. Such additional protection device might be useful either in the perspective of long duration procedure or in routine use.