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桡动脉心脏导管插入术期间的辐射剂量降低:专用桡动脉血管造影吸收屏蔽单的评估

Radiation Dose Reduction during Radial Cardiac Catheterization: Evaluation of a Dedicated Radial Angiography Absorption Shielding Drape.

作者信息

Ertel Andrew, Nadelson Jeffrey, Shroff Adhir R, Sweis Ranya, Ferrera Dean, Vidovich Mladen I

机构信息

Division of Cardiology, University of Illinois at Chicago Medical Center, Chicago, IL 60612, USA.

出版信息

ISRN Cardiol. 2012;2012:769167. doi: 10.5402/2012/769167. Epub 2012 Sep 4.

Abstract

Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exposure to patients and operators. Methods. Radiation doses to a simulated operator were measured with a RadCal Dosimeter in the cardiac catheterization laboratory. The mock patient was a 97.5 kg fission product phantom. Three lead-free drape designs were studied. The drapes were placed just proximal to the right wrist and extended medially to phantom's trunk. Simulated diagnostic coronary angiography included 6 minutes of fluoroscopy time and 32 seconds of cineangiography time at 4 standard angulated views (8 s each), both 15 frames/s. ANOVA with Bonferroni correction was used for statistical analysis. Results. All drape designs led to substantial reductions in operator radiation exposure compared to control (P < 0.0001). The greatest decrease in radiation exposure (72%) was with the L-shaped design. Conclusions. Dedicated radial shielding drapes decrease radiation exposure to the operator by up to 72% during simulated cardiac catheterization.

摘要

目的。辐射散射防护屏蔽帘的设计目的是在经股动脉导管插入术期间降低术者所受的辐射剂量。我们试图研究专门为桡动脉入路设计的各种屏蔽帘对术者辐射暴露的影响。背景。由于患者舒适度提高和出血并发症减少,心脏导管插入术的桡动脉入路有所增加。人们担心患者和术者的辐射暴露会增加。方法。在心脏导管插入实验室中,使用RadCal剂量仪测量模拟术者所接受的辐射剂量。模拟患者是一个97.5千克的裂变产物模型。研究了三种无铅帘布设计。将帘布放置在右腕近端并向内延伸至模型躯干。模拟诊断性冠状动脉造影包括6分钟的透视时间和在4个标准角度视图(每个视图8秒)下32秒的电影血管造影时间,两者均为每秒15帧。采用带有Bonferroni校正的方差分析进行统计分析。结果。与对照组相比,所有帘布设计均导致术者辐射暴露大幅降低(P < 0.0001)。辐射暴露降低幅度最大的是L形设计(72%)。结论。在模拟心脏导管插入术期间,专用的桡动脉屏蔽帘可使术者的辐射暴露降低多达72%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a1/3439952/24cbd7055fd0/ISRN.CARDIOLOGY2012-769167.001.jpg

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