April 18, 2012 -- NEW YORK (Reuters Health) - Pelvic lead shields reduce operator exposure to radiation during cardiac catheterization via radial or femoral approaches, German researchers have found.
But radial access -- increasingly used because it reduces vascular complications, patient discomfort, and costs -- "still remains associated with a higher operator radiation dose," even with the shield, the researchers reported this month in JACC: Cardiovascular Interventions.
Dr. Helmut W. Lange from Kardiologisch-Angiologische Praxis Herzzentrum Bremen and Dr. Heiner von Boetticher from Klinikum Links der Weser, also in Bremen, tested a pelvic lead shield during 210 elective outpatient coronary angiography procedures.
Fluoroscopy time was higher for the 107 radial cases than for the 103 femoral cases (2.7 versus 2.1 minutes; p < 0.001), but the radiation doses to patients were similar in the two groups.
Compared with standard protection, pelvic lead shielding reduced operator exposure from 20.9 mSv to 9.0 mSv when procedures were done with radial access and from 15.3 mSv to 2.9 mSv during femoral access cases.
The absolute reduction in dose-area product-normalized operator dose was the same for radial and femoral cases, but the overall exposure remained significantly higher during the radial cases.
"Although pelvic lead shielding is highly effective in reducing radiation," the researchers conclude, "it cannot close the 'radiation gap' for the operator between radial and femoral access."
They add, "We believe that further reductions in radiation exposure for radial operators are possible and should be aimed for, such as a combination of the pelvic lead shield and the protection board. These measures may eventually eliminate the difference in operator radiation exposure associated with the radial approach, which still exists today."
J Am Coll Cardiol Intv 2012;5:445-449.
Last Updated: 2012-04-17 17:35:23 -0400 (Reuters Health)
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