IRSA ASM 2024 Abstract

Abstract

Aim: Interventionalist experience high-lifetime radiation dosages due to the use of pulsed fluoroscopy. They also experience orthopaedic problems due to the necessity of wearing lead gowns to protect from this radiation. To alleviate both the radiation and orthopaedic issues, we trialled an innovative shielding system, Rampart (tm) which surrounds the patient's torso with lead equivalent acrylic shielding. Our trial period coincided with the initial COVID-19 outbreak and lockdowns which provided an additional use of the shielding as a protection from spread of COVID-19 infection from patients.

Method: Using Ray safe (tm) i3 Dosimeters, we measured primary operator radiation dosimetry. This was measured at the head (H), upper torso (T) and waist height (W). Both with the Rampart (tm) shield and without it. The measurements were conducted over a usual week's case load.

Results: 20 cases were performed, 10 with the Rampart (tm) system in place and 10 without. At the primary operator position we found an effective radiation attenuation of H: 70.3%, T: 98.3%, W: 99.5% with lead gowns. Compared to an effective radiation attenuation just using the Rampart(tm) external shielding of H: 89.3%, T: 92.4%, W: 89.0%. Using both lead gowns and the Rampart (tm) gave over 99.9 %. Airflow test also showed a laminar air flow away from the operator from the patient's head.

Conclusion: Whilst not as effective alone as lead gowns in radiation attenuation, the Rampart (tm) system was demonstrated to be an effective radiation safety device with the possibility of no lead or lighter lead use. Additional benefits that were observed from its use included significant radiation protection to the operator, protection to body areas not protected by lead, (head arms) as well shielding from direct aerosol contact with the patient which has proven to be an important consideration in the current COVID-19 pandemic.