A New Design of a Lead-Acrylic Shield for Staff Dose Reduction in Radial and Femoral Access Coronary Catheterization.

Abstract

Today's standard radiation protection during coronary angiography and percutaneous coronary interventions is the combined use of lead acrylic shields and table-mounted lower body protection. Ambient dose measurements, however, have shown that these protection devices need improvement. Using an anthropomorphic physical phantom, various scenarios were investigated with respect to personnel exposure: a) enlarging the shield b) adding a flexible protective curtain to the bottom side of the shield, and c) application of radioprotective patient drapes. For visualization of the dose reduction effect, Monte Carlo simulations were performed. The flexible curtain in contact with the patient's body reduces the ambient dose rate at the operator's position by up to (87.5% ± 7.1) compared to the situation with the bare shield. The use of both the flexible curtain and the patient drape reduces the ambient dose rate by up to (90.8% ± 7). Similar results were achieved for the assisting personnel when they were positioned next to the operator. In addition, the enlarged shield provides better protection of the head region of tall operators. Adding a flexible protective curtain to the bottom side of the shield can protect operators from high doses, especially for body parts which are not protected by lead aprons, e.g. head, and eye lenses. This may be important with respect to lower dose limits for eye lenses in future. The protective effect in real-life working conditions is still being evaluated in an ongoing clinical study. Lead acrylic shields need improvement for a better protection of head and eye lenses. An additional flexible lead curtain at the bottom of the shield can considerably reduce the operator dose. Using the additional lead curtain, lighter protection clothing can be worn. Special eye protection may be no longer needed in most applications.