Reduced radiation exposure in the cardiac catheterization laboratory with a novel vertical radiation shield

At a glance

Type of study

Original research, Prospective cohort study

Who was studied

Interventional cardiologists, Phantom or simulation (no people)

Size

n = 177 procedures

Topics

Room shielding and protective devicesDosimetry and monitoringDose reduction techniquesPatient dose

Summary based on

the full text

What it found

• In clinical procedures with horizontal radiation absorbing pads, adding the vertical radiation shield lowered operator wrist dose by 41.9% with no difference in air kerma, and the difference persisted after multivariate adjustment.

  Key figures: 41.9% reduction (15.2 ± 13.4 vs. 26.2 ± 31.4 μSv, p = .001); adjusted p < .001

• In phantom testing, VRS added to horizontal pads reduced mannequin dose rate by 59% in one lab and dose by 100% in a second lab.

  Key figures: 59% (p < .005); 100% (p = .016)

• Combined HRAP and VRS reduced mannequin dose rate by 80% compared with no shielding in phantom model A.

  Key figures: 80% (p < .005)

• Left anterior oblique (LAO)-caudal angulation produced the highest operator and patient exposure, two to four times other angles.

  Key figures: 2-4 times more radiation, p < .005

• 8-inch magnification increased air kerma and operator dose rate versus 10-inch; moving 40 cm from the access site lowered operator dose rate by 30%.

  Key figures: +86.5% mGray, +12.2% μSv/min; -30% at 40 cm, -47% at 120 cm

Limits to keep in mind

Clinical comparison was non-randomized and unblinded with imbalanced groups (magnification, sex, fluoroscopy time), from one institution with four cardiologists; only wrist dose measured, not head or eye, and VRS tested at a single angle and magnification in phantoms.

Related research summaries

• Determinants of operator and patient radiation exposure during cardiac catheterization: Insights from the RadiCure (RADIation reduction during cardiac catheterization using real-timE monitoring) trial (2015, Randomized trial)
• Obesity as a determinant of radiation burden in the cardiac catheterization laboratory (2026, Narrative review)
• Radiation protection practices in diagnostic and interventional cardiology: Position paper from Portuguese Association of Interventional Cardiology (2025, Guideline or consensus statement)
• Radiation Safety in Chronic Total Occlusion Percutaneous Coronary Intervention (2025, Narrative review)
• Radiation Exposure, Training, and Safety in Cardiology (2024, Narrative review)