Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial

Background—Several methods to reduce radiation exposure in the setting of coronary procedures are available on the market, and we previously showed that additional radiation shields reduce operator exposure during radial interventions. We set out to examine the efficacy of real-time personal dosimet...

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Autores principales:	Maximilian Olschewski, Helen Ullrich, Moritz Brandt, Sebastian Steven, Majid Ahoopai, Recha Blessing, Aniela Petrescu, Philip Wenzel, Thomas Munzel, Tommaso Gori
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	coronary artery disease coronary stenting radiation exposure Medicine R
Acceso en línea:	https://doaj.org/article/52975f678b3148afab648722b8103951
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spelling	oai:doaj.org-article:52975f678b3148afab648722b81039512021-11-25T18:01:58ZEffectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial10.3390/jcm102253502077-0383https://doaj.org/article/52975f678b3148afab648722b81039512021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5350https://doaj.org/toc/2077-0383Background—Several methods to reduce radiation exposure in the setting of coronary procedures are available on the market, and we previously showed that additional radiation shields reduce operator exposure during radial interventions. We set out to examine the efficacy of real-time personal dosimetry monitoring in a real-world setting of radial artery catheterization. Methods and Results—In an all-comer prospective, parallel study, consecutive coronary diagnostic and intervention procedures were performed with the use of standard radiation shield alone (control group) or with the addition of a real-time dosimetry monitoring system (Raysafe, Billdal, Sweden, monitoring group). The primary outcome was the difference in exposure of the primary operator among groups. Additional endpoints included patient, nurse, second operator exposure and fluoroscopy time. A total of 700 procedures were included in the analysis (<i>n</i> = 369 in the monitoring group). There were no differences among groups in patients’ body mass index (<i>p</i> = 0.232), type of procedure (intervention vs. diagnostic, <i>p</i> = 0.172), and patient sex (<i>p</i> = 0.784). Fluoroscopy time was shorter in the monitoring group (5.6 (5.1–6.2) min vs. 7.0 (6.1–7.7) min, <i>p</i> = 0.023). Radiation exposure was significantly lower in the monitoring group for the patient (135 (115–151) µSv vs. 208 (176–245) µSv, <i>p</i> < 0.0001) but not for the first operator (9 (7–11) µSv vs. 10 (8–11), <i>p</i> = 0.70) and the assistant (2 (1–2) µSv vs. 2 (1–2) µSv, <i>p</i> = 0.121). Conclusions—In clinical daily practice, the use of a real-time dosimetry monitoring device reduces patient radiation exposure and fluoroscopy time without an effect on operator radiation exposure.Maximilian OlschewskiHelen UllrichMoritz BrandtSebastian StevenMajid AhoopaiRecha BlessingAniela PetrescuPhilip WenzelThomas MunzelTommaso GoriMDPI AGarticlecoronary artery diseasecoronary stentingradiation exposureMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5350, p 5350 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coronary artery disease coronary stenting radiation exposure Medicine R
spellingShingle	coronary artery disease coronary stenting radiation exposure Medicine R Maximilian Olschewski Helen Ullrich Moritz Brandt Sebastian Steven Majid Ahoopai Recha Blessing Aniela Petrescu Philip Wenzel Thomas Munzel Tommaso Gori Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial
description	Background—Several methods to reduce radiation exposure in the setting of coronary procedures are available on the market, and we previously showed that additional radiation shields reduce operator exposure during radial interventions. We set out to examine the efficacy of real-time personal dosimetry monitoring in a real-world setting of radial artery catheterization. Methods and Results—In an all-comer prospective, parallel study, consecutive coronary diagnostic and intervention procedures were performed with the use of standard radiation shield alone (control group) or with the addition of a real-time dosimetry monitoring system (Raysafe, Billdal, Sweden, monitoring group). The primary outcome was the difference in exposure of the primary operator among groups. Additional endpoints included patient, nurse, second operator exposure and fluoroscopy time. A total of 700 procedures were included in the analysis (<i>n</i> = 369 in the monitoring group). There were no differences among groups in patients’ body mass index (<i>p</i> = 0.232), type of procedure (intervention vs. diagnostic, <i>p</i> = 0.172), and patient sex (<i>p</i> = 0.784). Fluoroscopy time was shorter in the monitoring group (5.6 (5.1–6.2) min vs. 7.0 (6.1–7.7) min, <i>p</i> = 0.023). Radiation exposure was significantly lower in the monitoring group for the patient (135 (115–151) µSv vs. 208 (176–245) µSv, <i>p</i> < 0.0001) but not for the first operator (9 (7–11) µSv vs. 10 (8–11), <i>p</i> = 0.70) and the assistant (2 (1–2) µSv vs. 2 (1–2) µSv, <i>p</i> = 0.121). Conclusions—In clinical daily practice, the use of a real-time dosimetry monitoring device reduces patient radiation exposure and fluoroscopy time without an effect on operator radiation exposure.
format	article
author	Maximilian Olschewski Helen Ullrich Moritz Brandt Sebastian Steven Majid Ahoopai Recha Blessing Aniela Petrescu Philip Wenzel Thomas Munzel Tommaso Gori
author_facet	Maximilian Olschewski Helen Ullrich Moritz Brandt Sebastian Steven Majid Ahoopai Recha Blessing Aniela Petrescu Philip Wenzel Thomas Munzel Tommaso Gori
author_sort	Maximilian Olschewski
title	Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial
title_short	Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial
title_full	Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial
title_fullStr	Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial
title_full_unstemmed	Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial
title_sort	effectiveness of a real-time x-ray dosimetry monitor in reducing radiation exposure in coronary procedures: the espresso-raysafe randomized trial
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/52975f678b3148afab648722b8103951
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Effectiveness of a Real-Time X-ray Dosimetry Monitor in Reducing Radiation Exposure in Coronary Procedures: The ESPRESSO-Raysafe Randomized Trial

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