Efficacy of RADPAD protection drape in reducing radiation exposure in the catheterization laboratory—First Indian study

BACKGROUND: Occupational radiation exposureis a growing problem due to increasing number and complexity of interventional procedures.The RADPAD is a lead-free sterile drape containing bismuth and barium that reduces scatter radiation during fluoroscopic procedures. We aimed to study the radiation exposure reduction to operators with the use of RADPAD and also measureradiation doses in different angiographic projections. METHODS: 65 randomly selected patients undergoing elective complex percutaneous coronary intervention (PCI) procedures from January 2017 to 2017 were randomized in a 1:1 pattern with or without the RADPAD. Primary endpoint was the ratio of operator received dose in mrem to total radiation in Gyat the end of the procedure which was designated ''Relative operator exposure'', with or without RADPAD. RESULTS: Despite similar fluoroscopy times (20.4 ± 9.4 min with RADPAD vs. 19.4 ± 9.2 min without RADPAD, P = 0.871) and total radiation dose (3.4 ± 4.3 Gy with RADPAD vs. 2.3 ± 1.4 Gy, P = 0.198), the relative operator exposure was significantly less with RADPAD (1.39 ± 0.95) as compared to no RADPAD group (2.27 ± 1.4) (p = 0.004) amounting to a 39% reduction. Additionally mean radiation dose per shoot of recorded Left anterior oblique (LAO) oriented projections was 34.4 ± 15.7mGyvs 24.9 ± 12.9 mGy for a non LAO oriented projection. (p < 0.001). CONCLUSION: RADPAD significantly reduces radiation exposure to the primary operator during prolonged complex PCI procedures. Further, amongst all views, LAO views have significantly higher emitted radiation as compared to Non LAO views and need more radiation protection.