A randomized study comparing the use of a pelvic lead shield during trans-radial interventions: Threefold decrease in...

Area of Science:

• Interventional Cardiology
• Medical Physics
• Radiation Safety

Background:

• Radial access in cardiac angiography offers benefits but increases radiation dose.
• Improved radiation protection strategies are crucial for patient and operator safety.
• Current protection methods may be insufficient during radial procedures.

Purpose of the Study:

• To evaluate the effectiveness of a 0.5-mm lead apron on patient's abdomen for reducing scatter radiation.
• To assess the impact of the lead apron on both operator and patient radiation exposure.
• To determine if additional lead shielding improves safety during radial angiography.

Main Methods:

• A randomized trial involving 332 patients undergoing coronary angiography.
• Comparison between a group with pelvic lead shielding and a group with standard protection.
• Measurement of operator and patient radiation doses using digital dosimeters at multiple sites.

Main Results:

• Pelvic lead shielding significantly reduced operator radiation dose at all measured sites (under apron, thyroid collar, head).
• Operator radiation dose decreased significantly with the use of the lead apron (P<0.001).
• Patient radiation dose at the umbilical level was doubled with the lead apron (P=0.04).

Conclusions:

• Pelvic lead shielding effectively lowers operator radiation exposure during radial angiography.
• The use of this shielding leads to a significant increase in patient radiation exposure.
• The risk-benefit balance requires further investigation prior to routine implementation.