The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

EffectivenesS of additional x-ray PRotection dEviceS in reducing Scattered radiation in radial interventiOn: the ESPRESSO randomized trial

DOI: 10.4244/EIJ-D-19-00945

1. Kardiologie I Universitätsmedizin Mainz and DZHK Standort Rhein-Main, Germany
2. Kardiologie I, Universitätsmedizin Mainz, and DZHK Standort Rhein-Main, Germany, Germany

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Aims:—We examine the impact of three different radiation protection devices in a real-world setting of radial artery catheterization.

Methods and results:— In an all-comer randomized trial, consecutive coronary radial diagnostic and intervention procedures were assigned in 1:1:1 ratio to shield-only protection (shield group), shield and overlapping 0.5mm Pb panel curtain (shield+curtain group) or shield, curtain and additional 75x40cm, 0.5mm Pb drape placed across the waist of the patient (shield+curtain+drape group).A total of 614 radial procedures were randomized (n=193 shield, n=220 shield+curtain, n=201 shield+curtain+drape). There were no differences among groups in patients’ or procedural characteristics. The primary endpoint (relative exposure ratio between operator’s exposure in μSv and patient exposure, dose area product in cGy·cm2) was significantly lower in the shield+curtain+drape group for both first operator (20% reduction vs shield, 16% vs shield+curtain, p=0.025) and assistant (39% reduction vs shield, 25% vs shield+curtain, p=0.009).

Conclusions:— The use of an additional drape reduced radiation exposure of both the first and second operator during routine radial procedures; a shield-attached curtain alone was only partially effective.

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