First Report of Lead-Free Neurointerventional Angiography Using Rampart System

Introduction Diagnostic neurointerventional angiography (DNA) is an increasingly common procedure to evaluate the health status of patient blood vessels. However, due to the volume of angiographies performed, this poses significant long‐term radiation risks to hospital staff. Although the use of protective lead aprons are effective against radiation protection, they pose significant physical stress. The Rampart system is marketed to offer radiation protection for the entire intervention team while eliminating the need for personal lead. While this system is available in interventional cardiology procedures, the system has yet to be evaluated for its radiation effectiveness and workflow optimization in DNA procedures. This abstract presents the first description of Rampart use for diagnostic angiography. Methods A configuration to measure radiation levels at key points in the neurointerventional suite was planned, resulting in a prospectively maintained database of radiation dose with and without Rampart usage. Geiger meters were positioned on the primary and secondary operators, as well as the circulating nurse. For the control, a Geiger meter was placed near the patient's head, measuring the maximum radiation endured during the intervention. Radiation values were recorded immediately after each procedure, and the database was later retrospectively reviewed for analysis Results During the study period, a total of 12 diagnostic angiographies were performed using the Rampart system for radiation shielding. The average control radiation dose was 192.2 ± 284.7 mRem, with the radiation dose for the physician being 0.13 ± 0.24 mRem. Our control cases consisted of wearing the traditional attire of full‐body leaded aprons and occurred in 4 cases. Radiation values for these cases were collected for the patient (78.8 ± 27.2 mRem), the physician performing the angiography (1.6 ± 0.6 mRem), and the anesthesiologist (0.2 ± 0.2 mRem). Conclusion Rampart technology is a safe and effective method for eliminating radiation in the neurointerventional suite without the need for personal lead aprons. In this study, Rampart technology did not interfere with any aspect of the procedure.