Kherad B, Jerichow T, Blaschke F, Noutsias M, Pieske B, Tschöpe C, Krackhardt F
Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany.
Privatpraxis Dr. Kherad, Große Hamburger Straße 5-11, Berlin, Germany.
Herz. 2018 Jun;43(4):310-314. doi: 10.1007/s00059-017-4560-7. Epub 2017 Apr 7.
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.
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.
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/m for the RADPAD group vs. 27.9 ± 5.5 kg/m for the control group, p = 0.8). Moreover, there was no difference in the dose-area ratio (1337 ± 582 cGy/cm for the RADPAD group vs. 1541 ± 804 cGy/cm 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).
The RADPAD significantly reduces radiation exposure to primary operators during routine diagnostic coronary angiography in patients with a BMI > 25 kg/m. It reduces total radiation exposure to primary operators by 59%, and the radiation exposure rate by 47%.
电离辐射是经皮冠状动脉造影不可或缺的一部分。长期暴露于低剂量辐射会使导管实验室工作人员面临皮肤损伤、晶状体混浊或白内障以及恶性疾病的风险。RADPAD是一种无菌手术单，可降低散射辐射对操作人员的影响。我们试图评估RADPAD防护罩在减少常规诊断性冠状动脉造影期间操作人员所受辐射剂量方面的效果。
连续60例计划进行择期冠状动脉造影的患者按1:1比例随机分组，分别在使用和不使用RADPAD手术单的情况下进行手术。对主操作人员的左臂进行剂量测定。
两组辐射暴露的两个主要决定因素无显著差异：筛查时间（RADPAD组为102±86秒，对照组为105±36秒，p = 0.9）和体重指数（BMI；RADPAD组为27.7±4.2kg/m，对照组为27.9±5.5kg/m，p = 0.8）。此外，两组患者的剂量面积比也无差异（RADPAD组为1337±582cGy/cm，对照组为1541±804cGy/cm，p = 0.3）。RADPAD组主操作人员的辐射剂量显著低于对照组，分别为8.0µSv（第一四分位数：3.2，第三四分位数：20.1）和19.6µSv（第一四分位数：7.1，第三四分位数：37.7）（p = 0.02）。
对于BMI>25kg/m的患者，RADPAD在常规诊断性冠状动脉造影期间能显著降低主操作人员的辐射暴露。它使主操作人员的总辐射暴露降低了59%，辐射暴露率降低了47%。
