title: Impact of a Disposable Sterile Radiation Shield on Operator Radiation Exposure During Percutaneous Coronary Intervention of Chronic Total Occlusions.
abstract: BACKGROUND
  Daily radiation exposure over many years can adversely impact the health of medical professionals.
  
  
  METHODS
  Operator radiation exposure was recorded for 124 percutaneous coronary interventions (PCIs) performed at our institution between August 2011 and May 2013: 69 were chronic total occlusion (CTO)-PCIs and 55 were non-CTO PCIs. A disposable radiation protection sterile drape (Radpad; Worldwide Innovations & Technologies, Inc) was used in all CTO-PCI cases vs none of the non-CTO PCI cases. Operator radiation exposure was compared between CTO and non-CTO PCIs.
  
  
  RESULTS
  Mean age was 64.6 ± 6.2 years and 99.2% of the patients were men. Compared with non-CTO PCI, patients undergoing CTO-PCI were more likely to have congestive heart failure, to be current smokers, and to have longer lesions, and less likely to have prior PCI and a saphenous vein graft target lesion. CTO-PCI cases had longer procedural time (median: 123 minutes [IQR, 85-192 minutes] vs 27 minutes [IQR, 20-44 minutes]; P<.001), fluoroscopy time (35 minutes [IQR, 19-54 minutes] vs 8 minutes [IQR, 5-16 minutes]; P<.001), number of stents placed (2.4 ± 1.5 vs 1.7 ± 0.9; P<.001), and patient air kerma radiation exposure (3.92 Gray [IQR, 2.48-5.86 Gray] vs 1.22 Gray [IQR, 0.74-1.90 Gray]; P<.001), as well as dose area product (267 Gray•cm² [IQR, 163-4.25 Gray•cm²] vs 84 Gray•cm² [IQR, 48-138 Gray•cm²]; P<.001). In spite of higher patient radiation exposure, operator radiation exposure was similar between the two groups (20 μSv [IQR, 9.5-31 μSv] vs 15 μSv [IQR, 7-23 μSv]; P=.07).
  
  
  CONCLUSIONS
  Operator radiation exposure during CTO-PCI can be reduced to levels similar to less complicated cases with the use of a disposable sterile radiation protection shield.
authors.affiliation: VA North Texas Health Care System, Cardiology, 4500 South Lancaster Road, Dallas, TX 75216 USA. esbrilakis@gmail.com.
authors.forename: Deborah
authors.initials: D
authors.lastname: Shorrock
authors.forename: Georgios
authors.initials: G
authors.lastname: Christopoulos
authors.forename: Jedrek
authors.initials: J
authors.lastname: Wosik
authors.forename: Anna
authors.initials: A
authors.lastname: Kotsia
authors.forename: Bavana
authors.initials: B
authors.lastname: Rangan
authors.forename: Shuaib
authors.initials: S
authors.lastname: Abdullah
authors.forename: Daisha
authors.initials: D
authors.lastname: Cipher
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000601:surgery; D004209:Disposable Equipment; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D000067393:Personal Protective Equipment; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome