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Canadian Journal of Cardiology

Performance of a Radiation Protection Cabin During Extraction of Cardiac Devices

Published:August 22, 2014DOI:https://doi.org/10.1016/j.cjca.2014.08.011

      Abstract

      Background

      Operators who extract cardiac devices are exposed to considerable irradiation and excess risk of radiation-induced disorders. A dedicated radioprotection cabin was developed to offer complete protection against radiation. This randomized study was designed to ascertain the protection against radiation conferred by a radioprotection cabin and the safety during extraction of cardiac devices.

      Methods

      Thirty-seven consecutive patients who presented with an indication for extraction of a cardiac device were randomly assigned to a standard extraction technique (n = 19), vs extraction with the use of a radiation protection cabin (n = 18). Fluoroscopic exposure was compared using electronic dosimeters placed on the thorax, back, foot, and head of the operator.

      Results

      The procedural times and total fluoroscopic exposure times and the complication rates were not significantly different between the 2 groups. The mean dose of radiation delivered to the thorax and back was similar in both groups (P = 0.3 and P = 0.8, respectively). In contrast, the mean doses of radiation delivered to the head and to the feet were respectively 68 and 390 times less in the cabin group than in the control group (P < 0.001).

      Conclusions

      The cabin offers nearly full body radioprotection and eliminates the need to wear a lead apron, without increasing procedural time or complication rate during cardiac device extraction.

      Résumé

      Introduction

      Les opérateurs qui procèdent à l’extraction des dispositifs cardiaques sont exposés à une irradiation importante et un risque additionnel de troubles radio-induits. Une cabine de radioprotection a été conçue expressément pour offrir une protection complète contre la radiation. Cette étude aléatoire a été réalisée pour vérifier la protection qu’offre la cabine de radioprotection contre les radiations et la sécurité durant l’extraction des dispositifs cardiaques.

      Méthodes

      Trente-sept (37) patients consécutifs qui présentaient une indication d’extraction d’un dispositif cardiaque ont été choisis de manière aléatoire pour subir une technique d’extraction standard (n = 19) vs une technique d’extraction comportant l’utilisation d’une cabine de radioprotection (n = 18). L’exposition radioscopique a été comparée en utilisant les dosimètres électroniques placés sur le thorax, le dos, le pied et la tête de l’opérateur.

      Résultats

      Les durées d’intervention, les durées d’exposition radioscopique totales et les taux de complications ne différaient pas de manière significative entre les 2 groupes. La dose moyenne de radiations auxquelles le thorax et le dos étaient exposés était similaire dans les 2 groupes (P = 0,3 et P = 0,8, respectivement). En revanche, les doses moyennes de radiations auxquelles la tête et le pied étaient exposés étaient respectivement de 68 et de 390 fois moindres dans le groupe utilisant la cabine que dans le groupe témoin (P < 0,001).

      Conclusions

      La cabine offre une radioprotection corporelle presque entière et dispense du port d’un tablier de plomb, sans augmenter la durée d’intervention ou le taux de complications durant l’extraction du dispositif cardiaque.
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