Impact of an extension tube on operator radiation exposure during coronary procedures performed through the radial approach

Abstract

Background: Operator radiation exposure is high during coronary procedures. The radial access decreases the rate of local vascular complications but increases operator radiation exposure. As the X-ray exposure is related to the distance between the operator and the radiation source, the use of an extension tube between the proximal part of the coronary catheter and the 'injection device' might decrease operator radiation exposure.

Aims: To demonstrate that the use of an extension tube during coronary procedures performed through the radial approach decreases operator radiation.

Methods: Overall, 230 patients were included consecutively and randomized to procedures performed with or without an extension tube. Radiation exposure measures were obtained using two electronic dosimeters, one under the lead apron and the other exposed on the physician's left arm.

Results: A non-significant trend towards lower left-arm operator exposure was noted in the extension tube group (28.7+/-31.0microSv vs 38.4+/-44.2microSv, p=0.0739). No significant difference was noted according to the type of procedure. Radiation levels were low compared with the series published previously and decreased for each operator during the study.

Conclusion: The use of an extension tube did not reduce operator radiation exposure during procedures performed through the radial approach. However, physician awareness was increased during the study due to the use of an exposed electronic dosimeter. The use of exposed electronic dosimeters could therefore be recommended to allow operators to improve their protection techniques.