Key result
Real-time dosimetry monitoring during coronary procedures did not significantly reduce primary operator radiation exposure compared to standard shielding alone (9 vs 10 µSv, p=0.70).
Why the study?
Several methods to reduce radiation exposure during coronary procedures exist, but the efficacy of real-time personal dosimetry monitoring in radial artery catheterization was not established.
Does the addition of a real-time dosimetry monitoring system to standard radiation shields reduce operator radiation exposure during radial coronary procedures?
RCT (n=700)
Does the addition of a real-time dosimetry monitoring system to standard radiation shields reduce operator radiation exposure during radial coronary procedures?
Absolute Event Rate: 9% vs 10%
p-value: p=0.70
The use of a real-time dosimetry monitoring device during radial coronary procedures reduces patient radiation exposure and fluoroscopy time, but does not significantly decrease primary operator exposure.
Background—Several methods to reduce radiation exposure in the setting of coronary procedures are available on the market, and we previously showed that additional radiation shields reduce operator exposure during radial interventions. We set out to examine the efficacy of real-time personal dosimetry monitoring in a real-world setting of radial artery catheterization. Methods and Results—In an all-comer prospective, parallel study, consecutive coronary diagnostic and intervention procedures were performed with the use of standard radiation shield alone (control group) or with the addition of a real-time dosimetry monitoring system (Raysafe, Billdal, Sweden, monitoring group). The primary outcome was the difference in exposure of the primary operator among groups. Additional endpoints included patient, nurse, second operator exposure and fluoroscopy time. A total of 700 procedures were included in the analysis (n = 369 in the monitoring group). There were no differences among groups in patients’ body mass index (p = 0.232), type of procedure (intervention vs. diagnostic, p = 0.172), and patient sex (p = 0.784). Fluoroscopy time was shorter in the monitoring group (5.6 (5.1–6.2) min vs. 7.0 (6.1–7.7) min, p = 0.023). Radiation exposure was significantly lower in the monitoring group for the patient (135 (115–151) µSv vs. 208 (176–245) µSv, p < 0.0001) but not for the first operator (9 (7–11) µSv vs. 10 (8–11), p = 0.70) and the assistant (2 (1–2) µSv vs. 2 (1–2) µSv, p = 0.121). Conclusions—In clinical daily practice, the use of a real-time dosimetry monitoring device reduces patient radiation exposure and fluoroscopy time without an effect on operator radiation exposure.
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Olschewski et al. (2021) conducted an RCT in Coronary diagnostic and intervention procedures (n=700). Real-time dosimetry monitoring system vs. Standard radiation shield alone was evaluated on Difference in radiation exposure of the primary operator (p=0.70). Real-time dosimetry monitoring during coronary procedures did not significantly reduce primary operator radiation exposure compared to standard shielding alone (9 vs 10 µSv, p=0.70).
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