Efficacy of MAVIG X-Ray Protective Drapes in Reducing CTO Operator Radiation.

Thach N Nguyen,Keir Mccutcheon,Maarten Vanhaverbeke,Walter Desmet,Jérémie Dabin,Ruben Pauwels,Werner Schoonjans,Johan Bennett

doi:10.1155/2021/3146104

Abstract

Background The MAVIG X-ray protective drape (MXPD) has been shown to reduce operator radiation dose during percutaneous coronary interventions (PCI). Whether MXPDs are also effective in reducing operator radiation during chronic total occlusion (CTO) PCI, often with dual access, is unknown. Methods We performed a prospective, randomized-controlled study comparing operator radiation dose during CTO PCI (n = 60) with or without pelvic MXPDs. The primary outcomes were the difference in first operator radiation dose (μSv) and relative dose of the first operator (radiation dose normalized for dose area product) at the level of the chest in the two groups. The effectiveness of MXPD in CTO PCI was compared with non-CTO PCI using a patient-level pooled analysis with a previously published non-CTO PCI randomized study. Results The use of the MXPD was associated with a 37% reduction in operator dose (weighted median dose 26.0 (IQR 10.00–29.47) μSv in the drape group versus 41.8 (IQR 30.82–60.59) μSv in the no drape group; P < 0.001) and a 60% reduction in relative operator dose (median dose 3.5 (IQR 2.5–5.4) E/DAPx10−3 in the drape group versus 8.6 (IQR 4.2–12.5) E/DAPx10−3 in the no drape group; P=0.001). MXPD was equally effective in reducing operator dose in CTO PCI compared with non-CTO PCI (P value for interaction 0.963). Conclusions The pelvic MAVIG X-ray protective drape significantly reduced CTO operator radiation dose. This trial is clinically registered with https://www.clinicaltrials.gov (unique identifier: NCT04285944).

Highlights

Background. e MAVIG X-ray protective drape (MXPD) has been shown to reduce operator radiation dose during percutaneous coronary interventions (PCI)
MAVIG X-ray protective drape (MAVIG, Munich, Germany) are widely available, relatively small, light-weight, and reusable. ese drapes have been designed to protect against radiation emitting from the patient’s body during both femoral and radial access procedures, and we have previously demonstrated that they reduce operator radiation dose by half during routine cardiac catheterization and PCI [4]
chronic total occlusion (CTO) complexity (Table 1), fluoroscopy time, air kerma (Ka,r, mGy), and DAP use were similar in the two groups (Figure 1)

Summary

Introduction

Background. e MAVIG X-ray protective drape (MXPD) has been shown to reduce operator radiation dose during percutaneous coronary interventions (PCI). E MAVIG X-ray protective drape (MXPD) has been shown to reduce operator radiation dose during percutaneous coronary interventions (PCI). Introduction e main source of operator radiation during percutaneous coronary interventions (PCI) is scatter from the patient Reduction of this radiation is especially important in chronic total occlusion (CTO) PCI since these procedures are lengthy and are mostly carried out by dedicated operators. Ese drapes have been designed to protect against radiation emitting from the patient’s body during both femoral and radial access procedures, and we have previously demonstrated that they reduce operator radiation dose by half during routine cardiac catheterization and PCI [4]. We present the results of a prespecified parallel prospective randomized-controlled trial (RCT) where we measured operator radiation dose during CTO procedures with and without MAVIG X-ray protective drapes

Methods

Results

Discussion

Conclusion