Abstract
This study aimed to evaluate the effects of fogging on the effectiveness of a lead glass shield in protecting an operator from radiation exposure during conventional coronary angiography (CAG). Optically stimulated luminescence dosimeters (OSLDs) were used to measure the effects of fogged lead glass shields (FLSs) and clear lead glass shields (CLSs) on the radiation doses of a cardiac catheterization surgeon. We simulated the scatter radiation incident on the operator with five angiographic projections with 10-s exposures. Experiments were conducted with a field of view of 25 cm, maximum of 100 cm between the X-ray tube and image intensifier, and 80 cm between the image intensifier and operator. Lead glass fogging had no significant effect at any angiographic projection. The average dose at the lens of the eye, thyroid glands, and gonads did not differ significantly between FLS and CLS. Although most surgeons view ceiling-suspended shields as hindrances during surgical procedures, the radiation dose at the operator’s eyes and thyroid glands increased by 13 and 10 times without the shield. The fogging of the shield is probably caused by post-surgery UV decontamination or detergents. An operator has no cause for concern regarding the radiation protection afforded by an FLS during CAG procedures.
Highlights
Coronary angiography (CAG) and percutaneous coronary intervention (PCI) are safe and effective surgical procedures, with an overall complication rate of only 2% [1,2]
A clinical examination can be prolonged owing to variations in patient condition, which could lead to high radiation doses in the lenses of the operators’ eyes [4]
The average radiation doses of the thyroid gland with a horizontal fogged lead glass shields (FLSs) or clear lead glass shields (CLSs) were 91.33 ± 3.02 μGy and 91.00 ± 3.30 μGy (p = 0.94), respectively, and 97.00 ± 2.45 μGy and 95.00 ± 2.61 μGy with a vertical FLS or CLS (p = 0.78)
Summary
Coronary angiography (CAG) and percutaneous coronary intervention (PCI) are safe and effective surgical procedures, with an overall complication rate of only 2% [1,2]. Owing to the growing number of cardiac catheter devices and the increasing complexity of surgical procedures, cardiologists have been subjected to increasingly high radiation doses compared with ordinary radiologists [3]. A clinical examination can be prolonged owing to variations in patient condition, which could lead to high radiation doses in the lenses of the operators’ eyes [4]. Personal radiation protection equipment, such as lead aprons, thyroid shields and lead glasses, have become standard equipment in interventional fluoroscopy. Radiation protection accessories, such as ceiling-suspended lead shielding, table lead shielding and shielding placed on patients are used in clinical settings. Operators often use ceilingsuspended lead acrylic shields, as there are a number of materials that must be taken in and out during cardiac catheterization, including wires, balloon catheters and stents
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