title: Radioprotective lightweight caps in the interventional cardiology setting: a randomised controlled trial (PROTECT).
abstract: OBJECTIVE
  The aim of this study was to test the radioprotection efficacy and comfort of newer bilayer barium sulphate-bismuth oxide composite (XPF) caps in an interventional cardiology setting.
  
  
  RESULTS
  Operators were randomly assigned to wear standard fabric (n=59), 0.3 mm (n=74), or 0.5 mm (n=64) lead-equivalent XPF caps. Radiation doses were measured by using dosimeters placed outside and underneath the caps. Wearing comfort was assessed at the end of each measurement on a visual analogue scale (VAS) (0-100, with 100 indicating optimal comfort). Procedural data did not differ between the XPF and standard groups. Mean standard, XPF 0.3 mm, and XPF 0.5 mm cap weights were 12.5 g, 118.4 g, and 123.7 g, respectively. VAS comfort ratings of the standard and XPF caps did not differ significantly (p=0.272). The mean radiation protection was 12.0%, 95% CI: 4.9-19.1% (standard caps, n=35), 91.5%, 95% CI: 87.4-95.6% (XPF 0.3 mm caps, n=45) and 97.1%, 95% CI: 92.5-100% (XPF 0.5 mm caps, n=44) (p≤0.001 for all group comparisons). Using the XPF caps, a cumulative total radiation dose reduction by almost factor 10 was evident (272 procedures, 22,310 μSv outside the XPF caps, 2,770 μSv inside the caps).
  
  
  CONCLUSIONS
  Lightweight XPF caps show comparable comfort to standard fabric caps, but provide substantial radiation protection during fluoroscopy-guided cardiac interventions.
authors.affiliation: Department of Interventional Cardiology, Baptist Cardiac and Vascular Institute, Miami, FL, USA.
authors.forename: Heiko
authors.initials: H
authors.lastname: Uthoff
authors.forename: Ramon
authors.initials: R
authors.lastname: Quesada
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Roberts
authors.forename: Frederic
authors.initials: F
authors.lastname: Baumann
authors.forename: Melanie
authors.initials: M
authors.lastname: Schernthaner
authors.forename: Lynn
authors.initials: L
authors.lastname: Zaremski
authors.forename: Luv
authors.initials: L
authors.lastname: Hajirawala
authors.forename: Barry T
authors.initials: BT
authors.lastname: Katzen
authors.forename: Daniel
authors.initials: D
authors.lastname: Staub
authors.forename: Andreas S
authors.initials: AS
authors.lastname: Kreusch
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D016507:Cardiology Service, Hospital; D017023:Coronary Angiography / Q000379:methods; D004867:Equipment Design; D005471:Fluoroscopy; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D060051:Occupational Injuries / Q000209:etiology / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011446:Prospective Studies; D011481:Protective Clothing; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011834:Radiation Monitoring; D011835:Radiation Protection / Q000379:methods*; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D013557:Switzerland; D013784:Textiles; D013997:Time Factors