Role of Different Adjunctive Protective Devices to Reduce Operator Radiation Exposure in Percutaneous Coronary Procedures: The RAPTOR Study

Objective . To compare the relative effectiveness of different anti‐Rx devices in terms of radiation dose absorbed by operators during percutaneous coronary procedures (diagnostic or interventional). Background . Direct comparisons among different adjunctive anti‐Rx devices during percutaneous coronary procedures to reduce operator radiation exposure are lacking. Methods . We retrospectively analyzed the last 200 percutaneous procedures performed by a single operator according to the use of adjunctive protective devices (group 1) or standard anti‐Rx setting (group 2). Subsequently, the procedures in group 1 have been divided according to the protective device utilized (homemade pelvic drape with under‐table curtain, or RADPAD drape, or the STAR System device, or the Rampart shield). The primary endpoint was the operator radiation dose at the thorax. Results . Groups 1 and 2 did not show significant differences in terms of anthropometric data or cardiovascular risk factors. The use of adjunctive anti‐Rx devices was associated with a significant reduction in operator radiation exposure compared to standard radioprotection (12.8 μ Sv [7–21] and 22.6 μ Sv [11–36], respectively; p < 0.0001). Globally, the anti‐Rx devices utilized were associated with a reduced operator radiation exposure (11.7 μ Sv [2–19] for homemade drapes, 13.5 μ Sv [9–29] for RADPAD drape, 15 μ Sv [11–30] for STAR Board System, and 8 μ Sv [5–19] for Rampart; p < 0.0001) with the homemade drapes and the Rampart system showing a lower operator exposure. Conclusions . The use of anti‐Rx devices during percutaneous coronary procedures is associated with a significant lower operator radiation exposure with the greater effect obtained with pelvic drapes and the Rampart system.