Impact of Ceiling Suspended Shield Size on Primary Operator Radiation Dose During Coronary Angiography and Intervention

Introduction Radiation protection for operators performing coronary angiography (CA) and percutaneous coronary intervention (PCI) is important, with the occupational risks being increasingly recognised. The ceiling‐suspended lead acrylic shield is the most commonly used piece of radiation shielding equipment, with different models available. This study sought to measure the impact of shield size on operator dose (OD) in the clinical environment, with two readily available models. Methods Two identical cardiac catheterisation laboratories (cath labs) were used in this single centre study. Fluoroscopy time (FT) and kerma area product (KAP) measured procedural radiation exposure. Identical lower body shields were used in both rooms. The ceiling‐suspended lead acrylic shield was different in each room, with one being 35% larger and also having lead rubber pleats along the lower edge. OD was measured with a real‐time dosimeter (Raysafe i3) at the end of each procedure. Results FT and KAP were not significantly different between the two cath labs for 1021 CA and 441 PCI procedures respectively. OD for CA procedures was 9 μSv in cath lab 1 (large shield) and 12 μSv in cath lab 2 (standard shield) ( p < 0.001). For PCI procedures, the operator dose was 21 μSv in cath lab 1 (large shield) and 29 μSv in cath lab 2 (standard shield) ( p < 0.001). Conclusion In this study, with identical cath labs, and similar procedural dose and fluoroscopy times, OD was up to 43% lower with a larger lead acrylic shield when compared to a standard lead acrylic shield.