Evaluating Standard Shielding Versus Novel Enhanced Radiation Protection Devices in the Cardiac Catheterization...

Enhanced radiation protection devices (ERPDs) have the potential to reduce occupational risks in the cardiac catheterization laboratory. We aimed to investigate scatter radiation exposure to various cardiac catheterization laboratory members using 2 ERPDs.

We prospectively allocated cases to 3 different shielding conditions: standard shielding (group 1), EggNest Protect ERPD (group 2), and EggNest Complete ERPD (group 3). Real-time dosimetry was used to measure radiation exposure at 3 positions: primary operator (position 1), assistant (position 2), and circulating nurse (position 3). Effective dose equivalent was estimated (annualized to 300 cases/y).

A total of 135 patients were included in the study (mean age, 68±11 years; 73% men). For position 1, annualized effective dose equivalent -1 doses were 51.4 (19.1-101.3), 7.0 (2.3-21.5), and 2.4 (0.9-6.2) mRem for groups 1, 2, and 3, respectively (P<0.001) standard shielding versus Protect ERPD: 33.1 (95% CI, 11.1-62.9), standard shielding versus Complete ERPD: 41.4 (20.5-71.9). For position 2, annualized effective dose equivalent -1 doses were 2.8 (2.0-6.3), 1.1 (0.6-6.4), and 0.8 (0.3-2.7) mRem for groups 1, 2, and 3, respectively (P<0.001) standard shielding versus Protect ERPD: 33.1 (95% CI, 11.1-62.9), standard shielding versus Complete ERPD: 41.4 (20.5-71.9). For position 3, annualized effective dose equivalent -1 doses were 1.5 (0.6-4.0), 1.5 (0.3-2.4), and 0.8 (0.2-2.5) mRem for groups 1, 2, and 3, respectively (P=0.003) standard shielding versus Protect ERPD: 0.3 (-0.4 to 1.2), standard shielding versus Complete ERPD: 0.4 (-0.1 to 1.4). With the use of the EggNest Complete ERPD without a lead apron, annualized total effective doses are ≤1% of the recommended annual maximum for all positions.

Compared with standard shielding, ERPDs significantly lowered scatter radiation exposure to all members of the cardiac catheterization laboratory.