Effectiveness of radiation protective drape to reduce exposure in fluoroscopically-guided interventional procedures

Abstract

Introduction Because of the increasing number of fluoroscopically-guided interventional procedures, physicians may be exposed to high annual dose. Radioprotective equipment is therefore desirable. Purpose This study aimed to evaluate the effect of a disposable lead-free drape in reducing scatter radiation exposure for physicians and patients during percutaneous coronary intervention. Materials and methods Eye lens and extremity dose measurements, for CTO treatment, performed for about 30 procedures in two Belgian hospitals. Monte Carlo simulations performed with the MCNP-X code to investigate the influence of parameters such as beam projection, position of operator, shield-combinations, drape shapes and position on the scatter radiation to staff and patient. Doses to selected organs, eye lenses, hands, wrists and legs were calculated. Results Simulations showed an effective dose reduction to the physician ranging from 2% to 36%, mainly observable for RAO projections; physician’s hands were significantly affected (35% ÷ 80%). If the position of the pad is shifted upward by 5 cm the effective dose could be further decreased with 8%. Maximum 86%, 60% and 44% dose reductions were observed for the patient’s genitalia, bladder and gonads, respectively. Measurements showed reductions ranging from 34% to 90% to the eyes, without the use of glasses, mainly for less complex procedures. Conclusion In real practice several projections, shielding devices and operator positions are combined altogether and the overall effect of the pad could be less, but the significant result achieved for the unprotected cardiologist’s hands (observable in any set-up) is a significant accomplishment.