Efficacy of RADPAD protective drape during coronary angiography

Abstract

Background: Ionizing radiation is an integral part of percutaneous coronary angiographies. Chronic exposure to low-dose radiation confers a risk for skin damage, eye lens opacities or cataracts, and malignant diseases to staff in the catheter laboratory. The RADPAD is a sterile surgical drape that reduces the effect of scatter radiation on the operator. We sought to assess the efficacy of RADPAD shields in reducing radiation dose experienced by operators during routine diagnostic coronary angiography.

Patients and methods: Sixty consecutive patients due to undergo elective coronary angiography were randomized in a 1:1 pattern to have their procedures performed with and without the RADPAD drape in situ. Dosimetry was performed on the left arm of the primary operator.

Results: There was no significant difference in the two main determents of radiation exposure in both groups: the screening times (102 ± 86 s for the RADPAD group vs. 105 ± 36 s for the control group, p = 0.9) and body mass index (BMI; 27.7 ± 4.2 kg/m² for the RADPAD group vs. 27.9 ± 5.5 kg/m² for the control group, p = 0.8). Moreover, there was no difference in the dose-area ratio (1337 ± 582 cGy/cm² for the RADPAD group vs. 1541 ± 804 cGy/cm² for the control group, p = 0.3) between the two patient groups. The primary operator radiation dose was significantly lower in the RADPAD group at 8.0 µSv (Q1: 3.2, Q3: 20.1) compared with 19.6 µSv (Q1: 7.1, Q3: 37.7) for the control group (p = 0.02).

Conclusion: The RADPAD significantly reduces radiation exposure to primary operators during routine diagnostic coronary angiography in patients with a BMI > 25 kg/m². It reduces total radiation exposure to primary operators by 59%, and the radiation exposure rate by 47%.

Keywords: Body mass index; Coronary angiography; Femoral artery; Radiation exposure; Radiation protection.