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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Article info
Publication history
Published online: August 22, 2014
Accepted:
August 12,
2014
Received:
June 12,
2014
Footnotes
See page 1606 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
