TCT 2017: Cath lab radiation down 20% when lead-free pad placed on patient

Interventional cardiologists are exposed to chronic low-dose radiation, which can lead to adverse health conditions. At a Nov. 1 presentation at the Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium in Denver, Wieneke Vlastra, MD, reported a 20 percent decrease in radiation exposure for operators when a lead-free disposable pad was placed on the patient.

“The radiation dose received by the operator is highly variable per procedure and depends on experience level, radiation equipment, procedure type, and patient characteristics,” wrote Vlastra et al., in results concurrently published in Circulation: Cardiovascular Interventions. “An increase in number and complexity of procedures in the catheterization laboratory further increases operators’ exposure to scatter radiation.”

The study featured 766 patients undergoing coronary angiography (CAG) or percutaneous coronary interventions (PCI) between January and May 2017. The individuals were randomly assigned to three groups:

• 255 patients were given a sterile, disposable, lead-free shield, called the “RADPAD.”
• 256 used a sham protective shield group.
• 255 did not use any pad.

“This prospective, large-scale, sham-controlled, randomized study shows that the use of a lightweight, disposable, sterile shield attenuates the relative operators’ radiation exposure with 20 percent compared with conventional safety measures in CAG and PCI,” wrote Vlastra et al. “In addition, the use of RADPAD resulted in a 44 percent reduction of relative operator exposure compared with a sham shield in this study. This effect is consistent during different types of procedures.”

Additionally, the researchers found radiation exposure for patients with the sham pad was higher than those with no pad.

“It is hypothesized that the presence of a radiation protection shield such as the RADPAD induces a sense of security and may reduce the operator’s tendency to maintain an appropriate distance from the scatter radiation produced by the patient,” the authors wrote. “This false sense of security in the [sham group] might explain why the RADPAD is associated with a two-fold higher relative exposure reduction in the [sham group] compared with the [no pad] group.”

The study received funding from Philips and Worldwide Innovations & Technologies.