Interventional Radiologists: A Necessary Evolution of Leaded Protective Aprons Design

Guersen, J.; Cassagnes, L.; Mechin, Guillaume; Ravel, A.; Dumousset, E.; Boyer, L.; Chabrot, P.

doi:10.1016/j.jvir.2012.11.004

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…This is particularly important for protection of the axillary portion of the female breast. Some facilities favour aprons with shoulder protection to reduce this exposure (Guersen et al, 2013).…”

Section: Protective Apronsmentioning

confidence: 99%

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

López¹,

Dauer²,

Loose³

et al. 2018

Ann ICRP

152

115

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In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

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Section: Protective Apronsmentioning

confidence: 99%

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

López¹,

Dauer²,

Loose³

et al. 2018

Ann ICRP

152

115

View full text Add to dashboard Cite

show abstract

“…30,31 It is important to note that the scatter radiations from the patient are mainly incident from the left-anterior oblique direction, while the operator stands at the right side of the patient's right thigh in many interventional procedures performed via the femoral sheath. 6,12 This oblique incident angle of the scatter radiation is the main cause of the unprotected area through the arm hole.The assumption in a previous study that the lungs, breasts, and esophagus are entirely protected by the protective clothing may have been speculated from the setting that the scatter radiation is mainly incident from the anterior direction to the operator, like when performing the percutaneous transhepatic biliary drainage. 29 Assuming typical uses, protecting the left side of the operator is more important than protecting the right side, and this can be applied to optimize the weight and protective effect of the x-ray protective clothing.…”

Section: Discussionmentioning

confidence: 99%

“…However, most frequently, the operator stands on the right side of the patient's right thigh during the procedure, to manipulate devices through the sheath inserted in the right or left common femoral artery of the patient. [3][4][5][6] This position of the operator is typical in various major interventional radiology procedures, such as transarterial chemoembolization, radioembolization, gastrointestinal bleeding embolization, uterine artery embolization, bleeding embolization in trauma patients, endovascular repair of abdominal aortic aneurysm, and renal and iliac artery interventions. The radiation exposure to the operator performing these procedures can be substantial as these procedures tend to be complex and time-consuming.…”

Section: Introductionmentioning

confidence: 99%

“…We hypothesized that, in the circumstance where the scatter radiation is mainly incident from the left-anterior direction, the arm hole of the xray protective clothing acts as a significant unprotected area and, consequently, contributes to an increase in organ doses and effective dose of the interventional radiologist. 6 However, to the best of our knowledge, previous studies on the significance of the unprotected area via the arm hole of the x-ray protective clothing are limited. 6,16 We supposed that an additional x-ray protective shoulder guard covering the arm hole of the standard protective clothing could significantly decrease the operator's organ doses and effective dose.…”

Section: Introductionmentioning

confidence: 99%

“…6 However, to the best of our knowledge, previous studies on the significance of the unprotected area via the arm hole of the x-ray protective clothing are limited. 6,16 We supposed that an additional x-ray protective shoulder guard covering the arm hole of the standard protective clothing could significantly decrease the operator's organ doses and effective dose.…”

Section: Introductionmentioning

confidence: 99%

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Modified design of x‐ray protective clothing to enhance radiation protection for interventional radiologists

2023

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Background: In interventional radiology procedures, the operator typically stands on the right side of the patient's right thigh to manipulate devices through the femoral sheath. Because the standard x-ray protective clothing is designed as sleeveless and scatter radiations from the patient are mainly incident from the left-anterior direction to the operator, the arm hole of the clothing may be a significant unprotected area, contributing to an increase in the operator's organ doses and effective dose.Purpose: This study aimed to compare the organ doses and effective dose received by the interventional radiologist when wearing the standard x-ray protective clothing and when wearing the modified clothing with an additional shoulder guard. Methods: The experimental setup aimed to simulate actual clinical practice in interventional radiology. The patient phantom was located at the beam center to generate scatter radiation. An adult female anthropomorphic phantom loaded with 126 nanoDots (Landauer Inc., Glenwood, IL) was used to measure organ and effective doses to the operator. The standard wrap-around type x-ray protective clothing offered 0.25-mm lead-equivalent protection, and the frontal overlap area offered 0.50-mm lead-equivalent protection. The shoulder guard was custom-made with a material providing x-ray protection equivalent to lead of 0.50 mm thickness. The organ and effective doses were compared between the operator wearing the standard protective clothing and the one wearing the modified clothing with a shoulder guard. Results: After adding the shoulder guard, doses to the lungs, bone marrow, and esophagus decreased by 81.9%, 58.6%, and 58.7%, respectively, and the effective dose to the operator decreased by 47.7%. Conclusions: Widespread use of modified x-ray protective clothing with shoulder guards can significantly decrease the overall occupational radiation risk in interventional radiology.

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Radiation Stewardship: Radiation Exposure, Protection and Safety in Contemporary Endovascular Practice

Dawson

Haulon

2020

Mechanisms of Vascular Disease

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Interventional Radiologists: A Necessary Evolution of Leaded Protective Aprons Design

Cited by 7 publications

References 5 publications

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

Modified design of x‐ray protective clothing to enhance radiation protection for interventional radiologists

Radiation Stewardship: Radiation Exposure, Protection and Safety in Contemporary Endovascular Practice

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