Artifacts in fluoroscopy and changes in radiation dose caused by heating blankets and insulating covers during simulated endovascular treatment

Paweł Podsiadło,Grzegorz Liszka,Tomasz Sanak,Sylweriusz Kosiński,Tadeusz Popiela,Tomasz Darocha

doi:10.1007/s10140-020-01798-x

Paweł Podsiadło, Grzegorz Liszka + Show 4 more

Open Access

https://doi.org/10.1007/s10140-020-01798-x

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Abstract

PurposeWe aimed to assess whether insulating covers and warming systems cause artifacts in fluoroscopy, and whether they alter the radiation dose.MethodsEight insulating and warming systems were wrapped around the phantom in order to obtain images in fluoroscopy, and to measure the absorbed and scattered radiation dose. A dosimeter, endovascular catheters, and stents were placed into a phantom. The other dosimeter was placed outside of a C-arm table, at the operator’s and anesthesiologist’s locations.ResultsMost of the insulating covers did not cause artifacts in the fluoroscopy and led to a significant decrease in both the absorbed and scattered radiation dose. The highest decrease in the absorbed dose was observed with metalized foil (− 2.09%; p = 0.001) and in the scattered dose with Helios cover (− 55%; p < 0.001). Only one heating system (Ready Heat combined with Hypothermia Prevention and Management Kit cover) caused significant artifacts and increased radiation up to 99% (p < 0.001).ConclusionThermal insulation may be maintained during X-ray-guided emergency endovascular procedures in trauma victims. Self-heating blankets should be replaced with another warming system.

Highlights

Post-traumatic hypothermia is a well-known risk factor for mortality in trauma victims [1]
According to the Advanced Trauma Life Support recommendations, continuous prevention of hypothermia with blankets and warming devices is mandatory in trauma patients [9]
The highest decrease was caused by a threelayer wrapping (MF + blanket + metalized foil (MF)), which was − 2.09% (p = 0.001)

Summary

Introduction

Post-traumatic hypothermia is a well-known risk factor for mortality in trauma victims [1]. According to the Advanced Trauma Life Support recommendations, continuous prevention of hypothermia with blankets and warming devices is mandatory in trauma patients [9]. This may be provided by the passive warming (insulation) or devices which actively deliver the heat. Some doubts persist as to the potential of causing artifacts by certain materials used for heat balance improvement. While this has been studied on CT [10], no study assessed radiation changes and artifacts on fluoroscopy

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