Impact of a Novel Radiation Protection System on Door-to-Balloon Time During STEMI Intervention

Area of Science:

• Cardiology
• Interventional Cardiology
• Occupational Health

Background:

• Radiation exposure is an occupational hazard in catheterization labs.
• Lead aprons, used for protection, can cause orthopedic issues.
• Enhanced radiation protection systems aim to mitigate these risks.

Purpose of the Study:

• To evaluate the impact of the Rampart M1128 enhanced radiation protection system on door-to-balloon (D2B) time in ST-elevation myocardial infarction (STEMI) patients.
• To compare D2B times between patients treated with lead aprons versus the Rampart system.
• To assess if enhanced radiation protection compromises patient care quality.

Main Methods:

• Single-center retrospective cohort study.
• 174 STEMI patients undergoing percutaneous coronary intervention were analyzed (87 Rampart group, 87 lead apron group).
• Analyses were adjusted for potential confounders.

Main Results:

• Median D2B time was similar: 31.0 minutes (Rampart) vs 31.1 minutes (lead apron).
• Adjusted analysis showed no significant difference in D2B time (mean difference 1.51 minutes, P = .21), within the 5-minute noninferiority margin.
• No prolonged D2B times were observed in the Rampart group, even with shock or respiratory failure.

Conclusions:

• Enhanced radiation protection systems are noninferior to lead aprons for D2B time in STEMI.
• These systems enhance operator safety without compromising patient care.
• Wider adoption could reduce occupational harm while maintaining cardiovascular outcomes.