December 15, 2014

A randomized study comparing the use of a pelvic lead shield during trans‐radial interventions: Threefold decrease in radiation to the operator but double exposure to the patient

AMAnees MusallamMedStar Washington Hospital Center IVIna VolisRambam Health Care Campus SDSvetlana DadaevRambam Health Care Campus

Structured PICO

Does the use of a pelvic lead shield reduce operator radiation exposure during trans-radial interventions?

Population

Patients undergoing trans-radial interventions/angiography

Intervention

Use of a pelvic lead shield

Comparator

No pelvic lead shield

Outcome

Radiation dose to the operator (measured under lead apron, on thyroid collar, and left side of head) and radiation exposure to the patientsurrogate

While pelvic lead shielding during trans-radial interventions reduces operator radiation exposure, it significantly increases radiation exposure to the patient.

Abstract

Both groups were similar in BMI, procedures performed, and number of sequences. Usage of lead shielding statistically significantly reduced the radiation dose of the operator at all three sites measured: under lead apron all in µSv: 0.53 ± 1.4 vs. 0.17 ± 0.6, on thyroid collar 5.9 ± 7.7 vs. 2.9 ± 3.4, and left side of head 3.3 ± 3.4 vs. 2.1 ± 2.2, P<0.001. However the radiation to the patient was doubled from 15.4 ± 24.1 to 28.9 ± 81.1, P=0.04 CONCLUSIONS: The use of a pelvic lead shield during radial angiography reduced the operator radiation exposure at multiple measurement sites. However there was an increased exposure to the patient. This balance should be further investigated before the widespread adoption of this method. .

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