Efficacy of MAVIG X-Ray Protective Drapes in Reducing CTO Operator Radiation

Abstract

Background. The MAVIG X-ray protective drape (MXPD) has been shown to reduce operator radiation dose during percutaneous coronary interventions (PCI). Whether MXPDs are also effective in reducing operator radiation during chronic total occlusion (CTO) PCI, often with dual access, is unknown. Methods. We performed a prospective, randomized-controlled study comparing operator radiation dose during CTO PCI (n = 60) with or without pelvic MXPDs. The primary outcomes were the difference in first operator radiation dose (μSv) and relative dose of the first operator (radiation dose normalized for dose area product) at the level of the chest in the two groups. The effectiveness of MXPD in CTO PCI was compared with non-CTO PCI using a patient-level pooled analysis with a previously published non-CTO PCI randomized study. Results. The use of the MXPD was associated with a 37% reduction in operator dose (weighted median dose 26.0 (IQR 10.00–29.47) μSv in the drape group versus 41.8 (IQR 30.82–60.59) μSv in the no drape group; P < 0.001 ) and a 60% reduction in relative operator dose (median dose 3.5 (IQR 2.5–5.4) E/DAPx10−3 in the drape group versus 8.6 (IQR 4.2–12.5) E/DAPx10−3 in the no drape group; P = 0.001 ). MXPD was equally effective in reducing operator dose in CTO PCI compared with non-CTO PCI ( P value for interaction 0.963). Conclusions. The pelvic MAVIG X-ray protective drape significantly reduced CTO operator radiation dose. This trial is clinically registered with https://www.clinicaltrials.gov (unique identifier: NCT04285944).

Efficacy and User Experience of a Novel X-Ray Shield on Operator Radiation Exposure During Cardiac Catheterization: A Randomized Controlled Trial

“…Reusable shields have are in use but have to date only shown far only shown moderate efficacy ranging from 20% to 72%. 5,15,18,19 More recently, comprehensive ceiling table-or floor-mounted systems [10][11][12][13] have entered the market. These have gained traction, but to date, have not reached general uptake among interventional cardiologists.…”

“…Previous studies evaluating different x-ray shields placed on the patient have demonstrated highly variable reduction in ROD ranging from 20% to 72%. [5][6][7][8]15,18,19 In these studies, x-ray shield size, lead equivalency, and functionality were highly variable. There was, however, a trend toward larger shields yielding better operator protection, and the largest reduction in ROD being observed with a 2-piece shield in sterile draping.…”

Effect of an optimized X-ray blanket design on operator radiation dose in cardiac catheterization based on real-world angiography

“…In everyday practice the most common setup is a combination of table-and ceiling-mounted lead shields. This setup tends to leave a gap at patient level and recently there has been an increased focus on placing a X-ray blanket (XRB) on the patient to improve shielding continuity (S1 Fig) . Clinical trials have found highly variable effect with reductions in operator dose ranging from 20 to 76% [4][5][6][7][8][9][10], but size, design, shielding properties and positioning of the blanket were not standardized. Available XRBs are of limited size which may limit the protective effect.…”