Operator Pelvic Radiation Exposure during Percutaneous Coronary Procedures

OBJECTIVES: To evaluate operator pelvic radiation exposure during percutaneous coronary procedures. BACKGROUND: During percutaneous coronary procedures, the operator's pelvic region is close to the x-ray source and is probably exposed to more radiation than the operator's thorax. However, no data are available on the pelvic radiation exposure of interventional cardiologists. METHODS: The RADIANT study (NCT01974453) is a prospective, single-center, observational study evaluating operator radiation exposure during percutaneous coronary procedures using electronic dosimeters placed at thorax level. In the last period of the study enrollment, a single operator was also equipped with an adjunctive electronic dedicated dosimeter to evaluate pelvic radiation exposure. RESULTS: From a total of 2028 procedures included in the RADIANT study, operator pelvic doses were available for 138 procedures (68 right radial, 55 left radial, and 15 transfemoral). Median fluoroscopy time was 226 sec (interquartile range [IQR], 117-407 sec) and the dose-area product (DAP) was 15.3 Gy•cm2(IQR, 9.3-27.8 Gy•cm2). Radiation dose at pelvic region was significantly higher (40.1 μSv; IQR, 22.7-76.3 μSv) compared to thorax dose (5.6 μSv; IQR, 1.5-12 μSv; P<.001) even after normalization by DAP (2.98 μSv/Gy•cm2[IQR, 1.6-4.6 μSv/Gy•cm2] at pelvic vs 0.33 μSv/Gy•cm2[IQR, 0.11-0.81 μSv/Gy•cm2] at thorax level; P<.001). No significant differences were observed comparing pelvic dose in right radial (42 μSv), left radial (39 μSv), or femoral access (40 μSv; P≤.43). CONCLUSIONS: Operator radiation exposure to the pelvic region during percutaneous coronary procedures is significantly higher compared to thorax radiation dose independently of the vascular access site employed.