Fluoroscopically guided vascular and cardiac transcatheter procedures: a comparison of occupational and patient dose by anatomical region.
Circulator nurse
Fluoroscopic imaging
Occupational exposure
Patient dose
Scrub nurse
X-ray imaging
Journal
Physical and engineering sciences in medicine
ISSN: 2662-4737
Titre abrégé: Phys Eng Sci Med
Pays: Switzerland
ID NLM: 101760671
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
15
08
2022
accepted:
27
01
2023
pubmed:
7
3
2023
medline:
24
3
2023
entrez:
6
3
2023
Statut:
ppublish
Résumé
X-ray guided procedures are being performed by an increasing variety of medical specialties. Due to improvements in vascular transcatheter therapies, there is an increasing overlap of imaged anatomy between medical specialties. There is concern that non-radiology fluoroscopic operators may not have sufficient training to be well informed of the potential implications of radiation exposure and mitigation strategies to reduce dose. This was a prospective, observational, single center study to compare occupational and patient dose levels when imaging different anatomical regions during fluoroscopically guided cardiac and endovascular procedures. Occupational radiation dose was measured at the level of the temple of 24 cardiologists and 3 vascular surgeons (n = 1369), 32 scrub nurses (n = 1307) and 35 circulating nurses (n = 885). The patient dose was recorded for procedures (n = 1792) performed in three angiography suites. Abdominal imaging during endovascular aneurysm repair (EVAR) procedures was associated with a comparatively high average patient, operator and scrub nurse dose despite additional table-mounted lead shields. Air kerma was relatively high for procedures performed in the chest, and chest + pelvis. Higher dose area product and staff eye dose were recorded during procedures of the chest + pelvis due to the use of digital subtraction angiography to evaluate access route prior to/during transaortic valve implantation. Scrub nurses were exposed to higher average radiation levels than the operator during some procedures. Staff should be cognizant of the potentially higher radiation burden to patients and exposed personnel during EVAR procedures and cardiac procedures using digital subtraction angiography.
Identifiants
pubmed: 36877360
doi: 10.1007/s13246-023-01226-7
pii: 10.1007/s13246-023-01226-7
pmc: PMC10030543
doi:
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
353-365Informations de copyright
© 2023. The Author(s).
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