Real-Time Radiation Monitoring Device Reduced Operator Radiation Exposure
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
The Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring study sought to examine the effect of a radiation detection device that provides real-time operator dose reporting through auditory feedback (Bleeper Sv; Vertec Scientific Ltd; Berkshire, UK) on patient dose and operator exposure during cardiac catheterization.
METHODS AND RESULTS
Between January 2012 and May 2014, 505 patients undergoing coronary angiography, percutaneous coronary intervention, or both were randomized to use (n=253) or no use (n=252) of the Bleeper Sv radiation monitor. Operator radiation exposure was measured in both groups using a second, silent radiation exposure monitoring device. Mean patient age was 65±8 years, most patients (99%) were men, and 30% had prior coronary artery bypass graft surgery. Baseline clinical characteristics were similar in the 2 study groups. Radial access was used in 18% and chronic total occlusion percutaneous coronary intervention constituted 7% of the total procedures. Median procedure time was 17 (12-27) minutes for diagnostic angiography, 42 (28-70) minutes for percutaneous coronary intervention, and 27 (14-51) minutes in the overall study population, with similar distribution between the study groups. First (9 [4-17] versus 14 [7-25] μSv; P<0.001) and second (5 [2-10] versus 7 [4-14] μSv; P<0.001) operator radiation exposure was significantly lower in the Bleeper Sv group. Use of the device did not result in a significant reduction in patient radiation dose. The effect of the Bleeper Sv device on operator radiation exposure was consistent among various study subgroups.
CONCLUSIONS
Use of a real-time radiation monitoring device that provides auditory feedback can significantly reduce operator radiation exposure during cardiac catheterization.
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Additional Info
Disclosure statements are available on the authors' profiles:
Effect of a Real-Time Radiation Monitoring Device on Operator Radiation Exposure During Cardiac Catheterization: The Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring Study
Circ Cardiovasc Interv 2014 Nov 25;[EPub Ahead of Print], G Christopoulos, AC Papayannis, M Alomar, A Kotsia, TT Michael, BV Rangan, M Roesle, D Shorrock, L Makke, R Layne, R Grabarkewitz, D Haagen, S Maragkoudakis, A Mohammad, K Sarode, DJ Cipher, CE Chambers, S Banerjee, ES BrilakisFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Being unable to see or feel radiation, makes it much harder to protect ourselves (and our patients) from its numerous adverse consequences (mainly cancer). By the time we learn that we received a high dose of radiation (usually after the dosimeter readings become available) it is too late! There are, however, devices that can provide real time feedback to the interventional cardiologist (or any operator working with radiation) on the intensity of radiation exposure. One such device is the Bleeper Sv (Vertec Scientific Ltd; Berkshire, UK) that was tested in a randomized-controlled trial, the Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring (RadiCure) study. RadiCure showed that use of the Bleeper Sv during cardiac catheterization resulted in approximately 30% reduction in operator radiation exposure, likely due to operator behavioral modification in response to the device’s feedback (such as better shielding, optimizing patient positioning, and moving away from the X-ray beam).
Currently, there is intense focus on minimizing radiation exposure during X-ray procedures, for both the patient and the operator. This can be achieved in multiple ways, such as using low frame rate fluoroscopy (7.5 frames per second), limiting use of cine-angiography, and upgrading to newer X-ray equipment with radiation reducing software and hardware. The RadiCure study shows that a simple and low cost intervention (use of the Bleeper Sv radiation monitor) can significantly reduce operator radiation exposure, expanding our armamentarium in the “war” against the adverse effects of radiation.