The Efficacy of Shielding Systems for Reducing Operator Exposure during Neurointerventional Procedures: A Real-World Prospective Study

Miller, Timothy; Zhuo, Jiachen; Jindal, Gaurav; Shivashankar, Ravi; Beaty, Narlin; Gandhi, Dheeraj

doi:10.3174/ajnr.a5038

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…1 to reduce physician and patient radiation dose. Specific steps which may be taken by interventionalists to reduce patient and operator dose include the use of radiation-absorbing pads, which have been demonstrated to reduce physician radiation dose by approximately 70% during procedures using femoral artery access (Miller et al 2017 ; Fetterly et al 2011 ). Further, utilization of real-time image noise-reduction technology have demonstrated significant reductions in radiation doses across interventional radiology, cardiology, and neurointerventional radiology-performed interventions (Söderman et al 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopically-guided interventions with radiation doses exceeding 5000 mGy reference point air kerma: a dosimetric analysis of 89,549 interventional radiology, neurointerventional radiology, vascular surgery, and neurosurgery encounters

et al. 2020

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Purpose To quantify and categorize fluoroscopically-guided procedures with radiation doses exceeding 5000 mGy reference point air kerma (Ka,r). Ka,r > 5000 mGy has been defined as a “significant radiation dose” by the Society of Interventional Radiology. Identification and analysis of interventions with high radiation doses has the potential to reduce radiation-induced injuries. Materials and methods Radiation dose data from a dose monitoring system for 19 interventional suites and 89,549 consecutive patient encounters from January 1, 2013 to August 1, 2019 at a single academic institution were reviewed. All patient encounters with Ka,r > 5000 mGy were included. All other encounters were excluded (n = 89,289). Patient demographics, medical specialty, intervention type, fluoroscopy time (minutes), dose area product (mGy·cm2), and Ka,r (mGy) were evaluated. Results There were 260 (0.3%) fluoroscopically-guided procedures with Ka,r > 5000 mGy. Of the 260 procedures which exceeded 5000 mGy, neurosurgery performed 81 (30.5%) procedures, followed by interventional radiology (n = 75; 28.2%), neurointerventional radiology (n = 55; 20.7%), and vascular surgery (n = 49; 18.4%). The procedures associated with the highest Ka,r were venous stent reconstruction performed by interventional radiology, arteriovenous malformation embolization performed by neurointerventional radiology, spinal hardware fixation by neurosurgery, and arterial interventions performed by vascular surgery. Neurointerventional radiology had the highest mean Ka,r (7,799 mGy), followed by neurosurgery (7452 mGy), vascular surgery (6849 mGy), and interventional radiology (6109 mGy). The mean Ka,r for interventional radiology performed procedures exceeding 5000 mGy was significantly lower than that for neurointerventional radiology, neurosurgery, and vascular surgery. Conclusions Fluoroscopically-guided procedures with radiation dose exceeding 5000 mGy reference point air kerma are uncommon. The results of this study demonstrate that a large proportion of cases exceeding 5000 mGy were performed by non-radiologists, who likely do not receive the same training in radiation physics, radiation biology, and dose reduction techniques as radiologists.

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Section: Discussionmentioning

confidence: 99%

Fluoroscopically-guided interventions with radiation doses exceeding 5000 mGy reference point air kerma: a dosimetric analysis of 89,549 interventional radiology, neurointerventional radiology, vascular surgery, and neurosurgery encounters

et al. 2020

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“…The use of such drapes has been well explored in the literature for angiographic procedures, particularly in the cardiac catheterisation laboratory setting [6][7][8]. The research suggests there is a significant reduction of scattered radiation to staff in the vicinity of the patient [6][7][8][9][10][11]. However, it is essential to note that the torso of occupationally exposed staff is already protected from a radioprotective apron.…”

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The use of patient drapes for staff dose reduction in fluoroscopically-guided interventions

2019

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Is lead shielding of patients necessary during fluoroscopic procedures? A study based on kyphoplasty

2017

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The Efficacy of Shielding Systems for Reducing Operator Exposure during Neurointerventional Procedures: A Real-World Prospective Study

Cited by 3 publications

References 27 publications

Fluoroscopically-guided interventions with radiation doses exceeding 5000 mGy reference point air kerma: a dosimetric analysis of 89,549 interventional radiology, neurointerventional radiology, vascular surgery, and neurosurgery encounters

Fluoroscopically-guided interventions with radiation doses exceeding 5000 mGy reference point air kerma: a dosimetric analysis of 89,549 interventional radiology, neurointerventional radiology, vascular surgery, and neurosurgery encounters

The use of patient drapes for staff dose reduction in fluoroscopically-guided interventions

Is lead shielding of patients necessary during fluoroscopic procedures? A study based on kyphoplasty

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