Literature DB >> 26292583

Invasive Cardiologists Are Exposed to Greater Left Sided Cranial Radiation: The BRAIN Study (Brain Radiation Exposure and Attenuation During Invasive Cardiology Procedures).

Ryan R Reeves1, Lawrence Ang1, John Bahadorani1, Jesse Naghi1, Arturo Dominguez1, Vachaspathi Palakodeti1, Sotirios Tsimikas1, Mitul P Patel1, Ehtisham Mahmud2.   

Abstract

OBJECTIVES: This study sought to determine radiation exposure across the cranium of cardiologists and the protective ability of a nonlead, XPF (barium sulfate/bismuth oxide) layered cap (BLOXR, Salt Lake City, Utah) during fluoroscopically guided, invasive cardiovascular (CV) procedures.
BACKGROUND: Cranial radiation exposure and potential for protection during contemporary invasive CV procedures is unclear.
METHODS: Invasive cardiologists wore an XPF cap with radiation attenuation ability. Six dosimeters were fixed across the outside and inside of the cap (left, center, and right), and 3 dosimeters were placed outside the catheterization lab to measure ambient exposure.
RESULTS: Seven cardiology fellows and 4 attending physicians (38.4 ± 7.2 years of age; all male) performed diagnostic and interventional CV procedures (n = 66.2 ± 27 cases/operator; fluoroscopy time: 14.9 ± 5.0 min). There was significantly greater total radiation exposure at the outside left and outside center (106.1 ± 33.6 mrad and 83.1 ± 18.9 mrad) versus outside right (50.2 ± 16.2 mrad; p < 0.001 for both) locations of the cranium. The XPF cap attenuated radiation exposure (42.3 ± 3.5 mrad, 42.0 ± 3.0 mrad, and 41.8 ± 2.9 mrad at the inside left, inside center, and inside right locations, respectively) to a level slightly higher than that of the ambient control (38.3 ± 1.2 mrad, p = 0.046). After subtracting ambient radiation, exposure at the outside left was 16 times higher than the inside left (p < 0.001) and 4.7 times higher than the outside right (p < 0.001). Exposure at the outside center location was 11 times higher than the inside center (p < 0.001), whereas no difference was observed on the right side.
CONCLUSIONS: Radiation exposure to invasive cardiologists is significantly higher on the left and center compared with the right side of the cranium. Exposure may be reduced similar to an ambient control level by wearing a nonlead XPF cap. (Brain Radiation Exposure and Attenuation During Invasive Cardiology Procedures [BRAIN]; NCT01910272).
Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  fellow; fluoroscopy; invasive cardiology; radiation exposure

Mesh:

Substances:

Year:  2015        PMID: 26292583     DOI: 10.1016/j.jcin.2015.03.027

Source DB:  PubMed          Journal:  JACC Cardiovasc Interv        ISSN: 1936-8798            Impact factor:   11.195


  16 in total

Review 1.  Physician and Patient Radiation Exposure During Endovascular Procedures.

Authors:  Andrew M Goldsweig; J Dawn Abbott; Herbert D Aronow
Journal:  Curr Treat Options Cardiovasc Med       Date:  2017-02

2.  Letter from the Editor in Chief.

Authors:  Moussa Mansour
Journal:  J Innov Card Rhythm Manag       Date:  2018-09-15

3.  Effect of treatment technique on radiation exposure in mechanical thrombectomy for acute ischaemic stroke: A matched-pair analysis.

Authors:  Charlotte S Weyland; Ulf Neuberger; Fatih Seker; Simon Nagel; Peter Arthur Ringleb; Markus A Möhlenbruch; Martin Bendszus; Johannes Ar Pfaff
Journal:  Neuroradiol J       Date:  2020-05-18

4.  The importance of public health in radiology and radiation protection.

Authors:  Zuzana Bárdyová; Martina Horváthová; Katarína Pinčáková; Darina Budošová
Journal:  J Public Health Res       Date:  2021-03-12

5.  Current and Future Use of Robotic Devices to Perform Percutaneous Coronary Interventions: A Review.

Authors:  Elad Maor; Mackram F Eleid; Rajiv Gulati; Amir Lerman; Gurpreet S Sandhu
Journal:  J Am Heart Assoc       Date:  2017-07-24       Impact factor: 5.501

Review 6.  The Development of Robotic Technology in Cardiac and Vascular Interventions.

Authors:  Ali Pourdjabbar; Lawrence Ang; Ryan R Reeves; Mitul P Patel; Ehtisham Mahmud
Journal:  Rambam Maimonides Med J       Date:  2017-07-31

Review 7.  Radiation exposure, the forgotten enemy: Toward implementation of national safety program.

Authors:  Tarek A N Ahmed; Salma Taha
Journal:  Egypt Heart J       Date:  2016-11-15

8.  Assessing the level of radiation experienced by anesthesiologists during transfemoral Transcatheter Aortic Valve Implantation and protection by a lead cap.

Authors:  N Patrick Mayr; Gunther Wiesner; Angela Kretschmer; Johannes Brönner; Herbert Hoedlmoser; Oliver Husser; Albert M Kasel; Rüdiger Lange; Peter Tassani-Prell
Journal:  PLoS One       Date:  2019-01-30       Impact factor: 3.240

9.  Cardiology fellows-in-training are exposed to relatively high levels of radiation in the cath lab compared with staff interventional cardiologists-insights from the RECAP trial.

Authors:  W Vlastra; B E Claessen; M A Beijk; K D Sjauw; G J Streekstra; J J Wykrzykowska; M M Vis; K T Koch; R J de Winter; J J Piek; J P S Henriques; R Delewi
Journal:  Neth Heart J       Date:  2019-06       Impact factor: 2.380

10.  Letter from the Editor in Chief.

Authors:  Moussa Mansour
Journal:  J Innov Card Rhythm Manag       Date:  2020-03-15
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