Salcido-Rios Jose, McNamara David A, VanOosterhout Stacie, VanLoo Lisa, Redmond Meaghan, Parker Jessica L, Madder Ryan D
Division of Cardiology, Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan, USA.
Catheter Cardiovasc Interv. 2022 Mar;99(4):981-988. doi: 10.1002/ccd.30047. Epub 2021 Dec 30.
This study was performed to evaluate physician radiation doses with the use of a suspended lead suit.
Interventional cardiologists face substantial occupational risks from chronic radiation exposure and wearing heavy lead aprons.
Head-level physician radiation doses, collected using real-time dosimeters during consecutive coronary angiography procedures, were compared with the use of a suspended lead suit versus conventional lead aprons. Multiple linear regression analyses were completed using physician radiation doses as the response and testing patient variables (body mass index, age, sex), procedural variables (right heart catheterization, fractional flow reserve, percutaneous coronary intervention, radial access), and shielding variables (radiation-absorbing pad, accessory lead shield, suspended lead suit) as the predictors.
Among 1054 coronary angiography procedures, 691 (65.6%) were performed with a suspended lead suit and 363 (34.4%) with lead aprons. There was no significant difference in dose area product between groups (61.7 [41.0, 94.9] mGy·cm vs. 64.6 [42.9, 96.9] mGy·cm , p = 0.20). Median head-level physician radiation doses were 10.2 [3.2, 35.5] μSv with lead aprons and 0.2 [0.1, 0.9] μSv with a suspended lead suit (p < 0.001), representing a 98.0% reduced dose with suspended lead. In the fully adjusted regression model, the use of a suspended lead suit was independently associated with a 93.8% reduction (95% confidence interval: -95.0, -92.3; p < 0.001) in physician radiation dose.
Compared to conventional lead aprons, the use of a suspended lead suit during coronary angiography was associated with marked reductions in head-level physician radiation doses.
本研究旨在评估使用悬吊式铅衣时医生所接受的辐射剂量。
介入心脏病专家面临因长期辐射暴露以及穿着沉重铅围裙而带来的重大职业风险。
在连续的冠状动脉造影手术过程中，使用实时剂量计收集头部水平的医生辐射剂量，比较使用悬吊式铅衣与传统铅围裙的情况。使用医生辐射剂量作为反应变量，测试患者变量（体重指数、年龄、性别）、手术变量（右心导管插入术、血流储备分数、经皮冠状动脉介入治疗、桡动脉通路）以及屏蔽变量（辐射吸收垫、辅助铅屏蔽、悬吊式铅衣）作为预测变量，完成多元线性回归分析。
在1054例冠状动脉造影手术中，691例（65.6%）使用悬吊式铅衣进行，363例（34.4%）使用铅围裙进行。两组之间的剂量面积乘积无显著差异（61.7 [41.0, 94.9] mGy·cm对64.6 [42.9, 96.9] mGy·cm，p = 0.20）。使用铅围裙时头部水平医生辐射剂量的中位数为10.2 [3.2, 35.5] μSv，使用悬吊式铅衣时为0.2 [0.1, 0.9] μSv（p < 0.001），使用悬吊式铅衣时剂量降低了98.0%。在完全调整的回归模型中，使用悬吊式铅衣与医生辐射剂量降低93.8%独立相关（95%置信区间：-95.0，-92.3；p < 0.001）。
与传统铅围裙相比，在冠状动脉造影过程中使用悬吊式铅衣可使头部水平医生辐射剂量显著降低。
