Author + information
- Received March 29, 2017
- Revision received June 8, 2017
- Accepted July 9, 2017
- Published online January 15, 2018.
- Ryan D. Madder, MD∗ (, )
- Andrew LaCombe, MD,
- Stacie VanOosterhout, Med,
- Abbey Mulder, BSN, RN,
- Matthew Elmore, MA,
- Jessica L. Parker, MS,
- Mark E. Jacoby, MD and
- David Wohns, MD
- ↵∗Address for correspondence:
Dr. Ryan D. Madder, Frederik Meijer Heart & Vascular Institute, Spectrum Health, 100 Michigan Street NE, Grand Rapids, Michigan 49503.
Objectives This study was performed to determine if the use of an accessory lead shield is associated with a reduction in radiation exposure among staff members during cardiac catheterization.
Background Accessory lead shields that protect physicians from scatter radiation are standard in many catheterization laboratories, yet similar shielding for staff members is not commonplace.
Methods Real-time radiation exposure data were prospectively collected among nurses and technologists during 764 consecutive catheterizations. The study had 2 phases: in phase I (n = 401), standard radiation protection measures were used, and in phase II (n = 363), standard radiation protection measures were combined with an accessory lead shield placed between the staff member and patient. Radiation exposure was reported as the effective dose normalized to dose-area product (EDAP).
Results Use of an accessory lead shield in phase II was associated with a 62.5% lower EDAP per case among technologists (phase I: 2.4 [4.3] μSv/[mGy × cm2] × 10−5; phase II: 0.9 [2.8] μSv/[mGy × cm2] × 10−5; p < 0.001) and a 63.6% lower EDAP per case among nurses (phase I: 1.1 [3.1] μSv/[mGy × cm2] × 10−5; phase II: 0.4 [1.8] μSv/[mGy × cm2] × 10−5; p < 0.001). By multivariate analysis, accessory shielding remained independently associated with a lower EDAP among both technologists (34.2% reduction; 95% confidence interval: 20.1% to 45.8%; p < 0.001) and nurses (36.4% reduction; 95% confidence interval: 19.7% to 49.6%; p < 0.001).
Conclusions The relatively simple approach of using accessory lead shields to protect staff members during cardiac catheterization was associated with a nearly two-thirds reduction in radiation exposure among nurses and technologists.
This work was partially funded by a research grant from Corindus Vascular Robotics. Dr. Madder has received research support from and served on the advisory board of Corindus Vascular Robotics. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 29, 2017.
- Revision received June 8, 2017.
- Accepted July 9, 2017.
- 2018 American College of Cardiology Foundation