Effect of a Real-Time Radiation Monitoring Device on Operator Radiation Exposure During Cardiac Catheterization: The Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring Study

G. Christopoulos, A. C. Papayannis, M. Alomar, A. Kotsia, T. T. Michael, B. V. Rangan, M. Roesle, D. Shorrock, L. Makke, R. Layne, R. Grabarkewitz, D. Haagen (+7 others)
2014 Circulation. Cardiovascular Interventions  
R adiation exposure is invisible, 1-3 but may cause injury of both the patient and the operator. 4-11 Advances in imaging equipment 12 along with operator education 13,14 can significantly reduce radiation exposure. Despite the use of specialized dosimetry equipment in some centers, the current gold standard for radiation surveillance is personal dosimetry, whereby radiation values become available months after the procedure rather than immediately during the procedure. 15 Realtime operator
more » ... fication on radiation exposure could lead to behavioral modification that could further reduce radiation dose. The Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring (RadiCure) trial (ClinicalTrials. Background-The Radiation Reduction During Cardiac Catheterization Using Real-Time Monitoring study sought to examine the effect of a radiation detection device that provides real-time operator dose reporting through auditory feedback (Bleeper Sv; Vertec Scientific Ltd; Berkshire, UK) on patient dose and operator exposure during cardiac catheterization. Methods and Results-Between January 2012 and May 2014, 505 patients undergoing coronary angiography, percutaneous coronary intervention, or both were randomized to use (n=253) or no use (n=252) of the Bleeper Sv radiation monitor. Operator radiation exposure was measured in both groups using a second, silent radiation exposure monitoring device. Mean patient age was 65±8 years, most patients (99%) were men, and 30% had prior coronary artery bypass graft surgery. Baseline clinical characteristics were similar in the 2 study groups. Radial access was used in 18% and chronic total occlusion percutaneous coronary intervention constituted 7% of the total procedures. Median procedure time was 17 (12-27) minutes for diagnostic angiography, 42 (28-70) minutes for percutaneous coronary intervention, and 27 (14-51) minutes in the overall study population, with similar distribution between the study groups. First (9 [4-17] versus 14 [7-25] μSv; P<0.001) and second (5 [2-10] versus 7 [4-14] μSv; P<0.001) operator radiation exposure was significantly lower in the Bleeper Sv group. Use of the device did not result in a significant reduction in patient radiation dose. The effect of the Bleeper Sv device on operator radiation exposure was consistent among various study subgroups. Conclusions-Use of a real-time radiation monitoring device that provides auditory feedback can significantly reduce operator radiation exposure during cardiac catheterization. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01510353. (Circ Cardiovasc Interv. 2014;7:744-750.)
doi:10.1161/circinterventions.114.001974 pmid:25423958 fatcat:lvyqghtmd5f4lbvv2tx3olvgcy