Interventional Angiography: Radiation Protection for the Examiner by using Lead-free Gloves TC26-TC29
Dr. Peter Kamusella,
Consultant, Institute of Radiology, Roentgenpraxis Heide, Heide, Germany.
Introduction: Introduction: The radiation exposure to unprotected parts of the body requires special attention for the interventional radiologist. During angiographic procedures, hands are exposed to the direct X-ray beam and scattered radiation.
Aim: The aim of the study was to evaluate the radiation exposure of examiners hand with the use of lead-free X-ray protective gloves in clinical practice in terms of shielding and sense of touch. The aim of the study was to evaluate the radiation exposure of examiners hand with the use of lead-free X-ray protective gloves in clinical practice in terms of shielding and sense of touch.
Materials and Methods: Phantom measurements were conducted in the direct X-ray beam and the area of scattered radiation with and without shielding. Examiner measurements were determined in interventional angiographies in clinical routine of the lower limb in antegrade puncture technique through the femoral artery. In 24 out of 50 interventions, an elastic natural rubber latex glove with lead-free metal shielding against radiation was used. All measurements were performed with a direct dosimeter. After the intervention, an opinion of the examiner was requested for evaluation of the sense of touch.
Results: Phantom measurements; when using the protective glove in the direct X-ray beam, a significant increase of the Dose Area Product (DAP) (1084.2-1603.8 mGy*cm²; 67.6%; p<0.001) as well of the examiners hand dose (143-221.8 µSv; 64.5%; p<0.001) was observed. A significant reduction of the examiners hand dose was verifiable for scattered radiation (1.76-0.75 µSv; 42.6%; p<0.001). Examiner measurements; if protective gloves were used, a significant increase of the DAP (6183.2-10462.9 mGy*cm²; 59.1%; p<0.05) and decrease of the average dose rate (0.76-0.43 mSv/h; 56.6%) for the entire procedure was determined. The tactile sensitivity was assessed as not restricted (18/24).
Conclusion: The new generation of protective gloves is characterized by a shielding effect against X-ray scattered radiation, without restricting the sense of touch. A significant reduction in radiation doses to the examiner can be accomplished with these gloves in the area of scattered radiation only. If the gloves were used in the direct X-ray beam, especially while the artery puncture was performed, a significant increase of the dose values was observed.