Impact of robotics and a suspended lead suit on physician radiation exposure during percutaneous coronary intervention.

ABSTRACT

BACKGROUND: Reports of left-sided brain malignancies among interventional cardiologists have heightened concerns regarding physician radiation exposure. This study evaluated the impact of a suspended lead suit and robotic system on physician radiation exposure during percutaneous coronary intervention (PCI). METHODS: Real-time radiation exposure data were prospectively collected from dosimeters worn by operating physicians at the head- and chest-level during consecutive PCI cases. Exposures were compared in three study groups 1) manual PCI performed with traditional lead apparel; 2) manual PCI performed using suspended lead; and 3) robotic PCI performed in combination with suspended lead. RESULTS: Among 336 cases (86.6% manual, 13.4% robotic) performed over 30weeks, use of suspended lead during manual PCI was associated with significantly less radiation exposure to the chest and head of operating physicians than traditional lead apparel (chest 0.0 [0.1] µSv vs 0.4 [4.0] µSv, p<0.001; head 0.5 [1.9] µSv vs 14.9 [51.5] µSv, p<0.001). Chest-level radiation exposure during robotic PCI performed in combination with suspended lead was 0.0 [0.0] µSv, which was significantly less chest exposure than manual PCI performed with traditional lead (p<0.001) or suspended lead (p=0.046). In robotic PCI the median head-level exposure was 0.1 [0.2] µSv, which was 99.3% less than manual PCI performed with traditional lead (p<0.001) and 80.0% less than manual PCI performed with suspended lead (p<0.001). CONCLUSIONS: Utilization of suspended lead and robotics were observed to result in significantly less radiation exposure to the chest and head of operating physicians during PCI.