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Efficacy of RADPAD protective drape during coronary angiography

Wirksamkeit des RADPAD-Strahlenschutztuchs bei Koronarangiographien

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Abstract

Background

Ionizing radiation is an integral part of percutaneous coronary angiographies. Chronic exposure to low-dose radiation confers a risk for skin damage, eye lens opacities or cataracts, and malignant diseases to staff in the catheter laboratory. The RADPAD is a sterile surgical drape that reduces the effect of scatter radiation on the operator. We sought to assess the efficacy of RADPAD shields in reducing radiation dose experienced by operators during routine diagnostic coronary angiography.

Patients and methods

Sixty consecutive patients due to undergo elective coronary angiography were randomized in a 1:1 pattern to have their procedures performed with and without the RADPAD drape in situ. Dosimetry was performed on the left arm of the primary operator.

Results

There was no significant difference in the two main determents of radiation exposure in both groups: the screening times (102 ± 86 s for the RADPAD group vs. 105 ± 36 s for the control group, p = 0.9) and body mass index (BMI; 27.7 ± 4.2 kg/m2 for the RADPAD group vs. 27.9 ± 5.5 kg/m2 for the control group, p = 0.8). Moreover, there was no difference in the dose–area ratio (1337 ± 582 cGy/cm2 for the RADPAD group vs. 1541 ± 804 cGy/cm2 for the control group, p = 0.3) between the two patient groups. The primary operator radiation dose was significantly lower in the RADPAD group at 8.0 µSv (Q1: 3.2, Q3: 20.1) compared with 19.6 µSv (Q1: 7.1, Q3: 37.7) for the control group (p = 0.02).

Conclusion

The RADPAD significantly reduces radiation exposure to primary operators during routine diagnostic coronary angiography in patients with a BMI > 25 kg/m2. It reduces total radiation exposure to primary operators by 59%, and the radiation exposure rate by 47%.

Zusammenfassung

Hintergrund

Trotz der Verwendung von Strahlenschutzkleidung besteht durch die Streustrahlung eine Strahlenbelastung für den interventionell tätigen Kardiologen. RADPAD ist ein steriles Strahlenschutztuch, die die Belastung der Streustrahlung für den Untersucher reduziert. Die Autoren untersuchten, ob sich bereits bei diagnostischen Koronarangiographien die Belastung durch Streustrahlung für den Untersucher durch die Verwendung des RADPAD reduzieren lässt.

Methoden

Hierzu wurden 60 Patienten, bei denen eine diagnostische Koronarangiographie mit standardisiertem Untersuchungsablauf durchgeführt wurde, 1:1 randomisiert in eine Gruppe mit und eine ohne RADPAD.

Ergebnisse

Beide Gruppen zeigten hinsichtlich der Durchleuchtungszeit (105 ± 36 s in der Kontrollgruppe bzw. 102 ± 86 s in der Strahlenschutztuchgruppe, p = 0,9) und des Body-Mass-Index (27,9 ± 5,5 kg/m2 in der Kontrollgruppe bzw. 27,7 ± 4,2 kg/m2 in der Strahlenschutztuchgruppe, p = 0,98), welche die maßgeblichen Faktoren für die kumulative Streustrahlungsdosis sind, keine signifikanten Unterschiede. Auch hinsichtlich des Dosis-Flächen-Produkts (DFP) ergab sich zwischen beiden Gruppen kein Unterschied: Das DFP betrug in der Kontrollgruppe 1541 ± 804 cGy/cm2, in der Strahlenschutztuchgruppe 1337 ± 582 cGy/cm2 (p = 0,3). Die einwirkende Strahlenäquivalenzdosis erwies sich jedoch in Strahlenschutztuchgruppe mit 8,0 µSv (Q1: 3,2; Q3: 20,1) als signifikant geringer im Vergleich zu 19,6 µSv (Q1: 7,1; Q3: 37,7) in der Kontrollgruppe (p = 0,02).

Schlussfolgerung

Durch die Verwendung des Strahlenschutztuchs wurde im Vergleich zur Kontrollgruppe die Strahlenbelastung für den Untersucher bereits bei diagnostischen Koronarangiographien bei Patienten mit einem BMI > 25 kg/m2 signifikant reduziert. Insgesamt konnte die Strahlenbelastung des Untersuchers (−59 %) und die Strahlenbelastungsrate (−47 %) reduziert werden.

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Authors and Affiliations

  1. Department of Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany

    B. Kherad, F. Blaschke, B. Pieske, C. Tschöpe & F. Krackhardt

  2. Privatpraxis Dr. Kherad, Große Hamburger Straße 5–11, Berlin, Germany

    B. Kherad

  3. Department of Cardiology and Intensive Care Medicine, Vivantes Wenckebach-Klinkum, Berlin, Germany

    T. Jerichow

  4. Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany

    M. Noutsias

  5. German Heart Center (Deutsches Herzzentrum Berlin, DHZB), Berlin, Germany

    B. Pieske

  6. Berlin Center for Regenerative Therapies (BCRT), Berlin, Germany

    C. Tschöpe

  7. The German Center for Cardiovascular Disease (DZHK), Berlin, Germany

    B. Pieske & C. Tschöpe

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  1. B. Kherad
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Correspondence to B. Kherad.

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Conflict of interest

B. Kherad, T. Jerichow, F. Blaschke, M. Noutsias, B. Pieske, C. Tschöpe, and F. Krackhardt declare that they have no competing interests.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki of 1975 (in its most recently amended version). Informed consent was obtained from all patients included in the study.

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Kherad, B., Jerichow, T., Blaschke, F. et al. Efficacy of RADPAD protective drape during coronary angiography. Herz 43, 310–314 (2018). https://doi.org/10.1007/s00059-017-4560-7

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  • DOI: https://doi.org/10.1007/s00059-017-4560-7

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