Impact of X-Ray Protective Drapes on Operator and Patient Radiation Exposure During Cardiac Catheterization

Background: As cardiac catheterization operators are exposed to radiation exposure throughout their careers, optimal radiation protection is crucial. Our study was designed to assess the effects of supplementary protective measures beyond standard radiation protection attire and barriers, measuring their influence on scatter radiation exposure levels for both the operator and the patient. Aims: The objective of this trial is to assess the impact of a lead shield on scatter radiation exposure for both the operator and the patient. Methods: We conducted a prospective, randomized clinical trial in which procedures were allocated to incorporate the use of a reusable lead apron designed to shield the lower body of the patient. Both operators and patients were outfitted with real-time procedure-specific dosimeters to monitor exposure. All patients undergoing radial access procedures were entered into a randomization process. The study's dual primary outcomes included the relative operator dose above (RODt) and under (RODu) the protective gear, as well as the scatter patient radiation dose (RPD), which was calculated as the measured radiation exposure (mu Sv) standardized against the dose area product (DAP). Results: Out of 400 procedures that were randomized, data from 346 procedures was complete for analysis. The use of the pelvic shield resulted in a substantial decrease in the RODt and RODu, with reductions of 25% and 40%, respectively (p < 0.0001). There was also a 38% reduction observed in the scatter RPD. In patients with a high BMI, the effectiveness of the pelvic shield varied. Conclusion: Employing an auxiliary pelvic shield significantly diminishes scatter radiation exposure for both the operator and the patient.