Impact of robotics and a suspended lead suit on physician radiation exposure during percutaneous coronary intervention

Cardiovasc Revasc Med. 2017 Apr-May;18(3):190-196. doi: 10.1016/j.carrev.2016.12.011. Epub 2016 Dec 16.

Abstract

Background: Reports of left-sided brain malignancies among interventional cardiologists have heightened concerns regarding physician radiation exposure. This study evaluated the impact of a suspended lead suit and robotic system on physician radiation exposure during percutaneous coronary intervention (PCI).

Methods: Real-time radiation exposure data were prospectively collected from dosimeters worn by operating physicians at the head- and chest-level during consecutive PCI cases. Exposures were compared in three study groups: 1) manual PCI performed with traditional lead apparel; 2) manual PCI performed using suspended lead; and 3) robotic PCI performed in combination with suspended lead.

Results: Among 336 cases (86.6% manual, 13.4% robotic) performed over 30weeks, use of suspended lead during manual PCI was associated with significantly less radiation exposure to the chest and head of operating physicians than traditional lead apparel (chest: 0.0 [0.1] μSv vs 0.4 [4.0] μSv, p<0.001; head: 0.5 [1.9] μSv vs 14.9 [51.5] μSv, p<0.001). Chest-level radiation exposure during robotic PCI performed in combination with suspended lead was 0.0 [0.0] μSv, which was significantly less chest exposure than manual PCI performed with traditional lead (p<0.001) or suspended lead (p=0.046). In robotic PCI the median head-level exposure was 0.1 [0.2] μSv, which was 99.3% less than manual PCI performed with traditional lead (p<0.001) and 80.0% less than manual PCI performed with suspended lead (p<0.001).

Conclusions: Utilization of suspended lead and robotics were observed to result in significantly less radiation exposure to the chest and head of operating physicians during PCI.

Keywords: Occupational hazard; Percutaneous coronary intervention; Radiation safety; Robotic PCI.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Coronary Angiography / adverse effects
  • Coronary Angiography / methods
  • Equipment Design
  • Head / radiation effects
  • Humans
  • Lead*
  • Linear Models
  • Logistic Models
  • Multivariate Analysis
  • Occupational Exposure / adverse effects
  • Occupational Exposure / prevention & control*
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / methods*
  • Physicians*
  • Prospective Studies
  • Protective Clothing*
  • Radiation Dosage*
  • Radiation Dosimeters
  • Radiation Exposure / adverse effects
  • Radiation Exposure / prevention & control*
  • Radiation Monitoring / instrumentation
  • Radiation Protection / instrumentation*
  • Radiography, Interventional / adverse effects
  • Radiography, Interventional / methods
  • Risk Assessment
  • Risk Factors
  • Robotics*
  • Thorax / radiation effects
  • Time Factors

Substances

  • Lead