Efficacy of MAVIG X-Ray Protective Drapes in Reducing Operator Radiation Dose in the Cardiac Catheterization Laboratory

Abstract

Background: Interventional cardiologists are occupationally exposed to high doses of ionizing radiation. The MAVIG X-ray protective drape (MXPD) is a commercially available light weight, lead-free shield placed over the pelvic area of patients to minimize operator radiation dose. The aim of this study was to examine the efficacy of the MXPD during routine cardiac catheterization, including percutaneous coronary interventions. Methods: We performed a prospective, randomized controlled study comparing operator radiation dose during cardiac catheterization and percutaneous coronary intervention (n=632) with or without pelvic MXPD. We measured operator radiation dose at 4 sites: left eye, chest, left ring finger, and right ring finger. 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 2 groups. Results: The use of the MXPD was associated with a 50% reduction in operator radiation dose (median dose 30.5 [interquartile range, 23.0–39.7] µSv in no drape group versus 15.3 [interquartile range, 11.1–20.0] µSv in the drape group; P <0.001) and a 57% reduction in relative operator dose ( P <0.001). The largest absolute reduction in dose was observed at the left finger (median left finger dose for the no drape group was 104.9 [75.7–137.4] µSv versus 41.9 [32.6–70.6] µSv in the drape group; P <0.001). Conclusions: The pelvic MXPD significantly reduces first operator radiation dose during routine cardiac catheterization and percutaneous coronary intervention. REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT04285944.

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

“…In this prospective randomized trial, we report that CTO operator radiation is reduced by 37% with the MAVIG X-ray protective drape (MXPD), and when DAP is taken into consideration, the effective dose for the CTO operator is reduced by 60%. ese findings are in line with a previously published study with MXPD, which demonstrated a 57% reduction in relative operator radiation dose during routine cardiac catheterization and PCI [4].…”

“…e use of MXPD was associated with 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/DAP x 10 −3 in the drape group versus 8.6 (IQR 4.2-12.5) E/DAP x 10 −3 in the no drape group; P � 0.001) (Figure 2). Finally, we performed a pooled patient-level analysis combining the current CTO PCI data with the previously published data from the parallel MXPD study in non-CTO PCI [4]. Using factorial ANOVA, we could show that MXPDs were equally effective at reducing operator radiation in both non-CTO and CTO procedures (P value for interaction 0.963).…”

“…e study protocol was approved by the local ethical committee (study identifier S62469). Details of the methods, the cardiac catheterization facility, radiation measurements, and statistical analysis have been published previously [4]. e details of the catheterization theatres have been previously published, and no interaction between the treatment effect and theatre was found (P value for interaction 0.113).…”

“…MAVIG X-ray protective drape ® (MAVIG, Munich, Germany) are widely available, relatively small, light-weight, and reusable. ese drapes have been designed to protect against radiation emitting from the patient's body during both femoral and radial access procedures, and we have previously demonstrated that they reduce operator radiation dose by half during routine cardiac catheterization and PCI [4]. However, there is very little data on the effect of these devices during CTO PCI, which often involves dual access.…”

Semi-automatic positioning of the protective screen based on integration with C-arm X-ray device

“…Research in this domain goes in the direction of improving shielding efficiency or introducing additional barriers. In the first case, connecting additional drapes (attention is required to avoid placing the drapes within the primary beam, which may increase patient and operator exposure [1]) at the lower end of the screen seemed to be best [43,44]. The another approach involves the use of an additional mobile protection system [45,46] -which should not be viewed competitively with the present invention, or the concept of additional protection of the first (the most exposed) operator [47,48].…”