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Peer-reviewedCC BY-NC-NDJournal of the American Heart Association

Evaluating Standard Shielding Versus Novel Enhanced Radiation Protection Devices in the Cardiac Catheterization Laboratory

  • Raviteja R. Guddeti1
  • Christian W. Schmidt1
  • Robert F. Riley2
  • Jacob Kamen3
  • Jarrod Frizzell1
  • Korey Haddox1
  • James Kong1
  • Steven Rudick1
  • Sitaramesh Emani1
  • John. D. Corl1
  • Puvi Seshiah1
  • Timothy D. Henry1
3 more authors
  • Dean J. Kereiakes1
  • Samantha Tribble1
  • Santiago Garcia1
  1. 1The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital
  2. 2Overlake Medical Center
  3. 3Icahn School of Medicine at Mount Sinai
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Abstract

Background Enhanced radiation protection devices (ERPDs) have the potential to reduce occupational risks in the cardiac catheterization laboratory. We aimed to investigate scatter radiation exposure to various cardiac catheterization laboratory members using 2 ERPDs. Methods We prospectively allocated cases to 3 different shielding conditions: standard shielding (group 1), EggNest Protect ERPD (group 2), and EggNest Complete ERPD (group 3). Real‐time dosimetry was used to measure radiation exposure at 3 positions: primary operator (position 1), assistant (position 2), and circulating nurse (position 3). Effective dose equivalent was estimated (annualized to 300 cases/y). Results A total of 135 patients were included in the study (mean age, 68±11 years; 73% men). For position 1, annualized effective dose equivalent ‐1 doses were 51.4 (19.1–101.3), 7.0 (2.3–21.5), and 2.4 (0.9–6.2) mRem for groups 1, 2, and 3, respectively ( P <0.001) standard shielding versus Protect ERPD: 33.1 (95% CI, 11.1–62.9), standard shielding versus Complete ERPD: 41.4 (20.5–71.9). For position 2, annualized effective dose equivalent ‐1 doses were 2.8 (2.0–6.3), 1.1 (0.6–6.4), and 0.8 (0.3–2.7) mRem for groups 1, 2, and 3, respectively ( P <0.001) standard shielding versus Protect ERPD: 33.1 (95% CI, 11.1–62.9), standard shielding versus Complete ERPD: 41.4 (20.5–71.9). For position 3, annualized effective dose equivalent ‐1 doses were 1.5 (0.6–4.0), 1.5 (0.3–2.4), and 0.8 (0.2–2.5) mRem for groups 1, 2, and 3, respectively ( P =0.003) standard shielding versus Protect ERPD: 0.3 (−0.4 to 1.2), standard shielding versus Complete ERPD: 0.4 (−0.1 to 1.4). With the use of the EggNest Complete ERPD without a lead apron, annualized total effective doses are ≤1% of the recommended annual maximum for all positions. Conclusions Compared with standard shielding, ERPDs significantly lowered scatter radiation exposure to all members of the cardiac catheterization laboratory.

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Cite

BibTeXRIS
BibTeX
@article{guddeti2026evaluating,
  title = {{Evaluating Standard Shielding Versus Novel Enhanced Radiation Protection Devices in the Cardiac Catheterization Laboratory}},
  author = {Raviteja R. Guddeti and Christian W. Schmidt and Robert F. Riley and Jacob Kamen and Jarrod Frizzell and Korey Haddox and James Kong and Steven Rudick and Sitaramesh Emani and John. D. Corl and Puvi Seshiah and Timothy D. Henry and Dean J. Kereiakes and Samantha Tribble and Santiago Garcia},
  journal = {Journal of the American Heart Association},
  year = {2026},
  month = oct,
  doi = {10.1161/jaha.126.050577},
  url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.050577},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Evaluating Standard Shielding Versus Novel Enhanced Radiation Protection Devices in the Cardiac Catheterization Laboratory
AU  - Raviteja R. Guddeti
AU  - Christian W. Schmidt
AU  - Robert F. Riley
AU  - Jacob Kamen
AU  - Jarrod Frizzell
AU  - Korey Haddox
AU  - James Kong
AU  - Steven Rudick
AU  - Sitaramesh Emani
AU  - John. D. Corl
AU  - Puvi Seshiah
AU  - Timothy D. Henry
AU  - Dean J. Kereiakes
AU  - Samantha Tribble
AU  - Santiago Garcia
PY  - 2026
DA  - 2026/10/20
JO  - Journal of the American Heart Association
DO  - 10.1161/jaha.126.050577
UR  - https://www.ahajournals.org/doi/10.1161/JAHA.126.050577
AB  - Background Enhanced radiation protection devices (ERPDs) have the potential to reduce occupational risks in the cardiac catheterization laboratory. We aimed to investigate scatter radiation exposure to various cardiac catheterization laboratory members using 2 ERPDs. Methods We prospectively allocated cases to 3 different shielding conditions: standard shielding (group 1), EggNest Protect ERPD (group 2), and EggNest Complete ERPD (group 3). Real‐time dosimetry was used to measure radiation exposure at 3 positions: primary operator (position 1), assistant (position 2), and circulating nurse (position 3). Effective dose equivalent was estimated (annualized to 300 cases/y). Results A total of 135 patients were included in the study (mean age, 68±11 years; 73% men). For position 1, annualized effective dose equivalent ‐1 doses were 51.4 (19.1–101.3), 7.0 (2.3–21.5), and 2.4 (0.9–6.2) mRem for groups 1, 2, and 3, respectively ( P <0.001) standard shielding versus Protect ERPD: 33.1 (95% CI, 11.1–62.9), standard shielding versus Complete ERPD: 41.4 (20.5–71.9). For position 2, annualized effective dose equivalent ‐1 doses were 2.8 (2.0–6.3), 1.1 (0.6–6.4), and 0.8 (0.3–2.7) mRem for groups 1, 2, and 3, respectively ( P <0.001) standard shielding versus Protect ERPD: 33.1 (95% CI, 11.1–62.9), standard shielding versus Complete ERPD: 41.4 (20.5–71.9). For position 3, annualized effective dose equivalent ‐1 doses were 1.5 (0.6–4.0), 1.5 (0.3–2.4), and 0.8 (0.2–2.5) mRem for groups 1, 2, and 3, respectively ( P =0.003) standard shielding versus Protect ERPD: 0.3 (−0.4 to 1.2), standard shielding versus Complete ERPD: 0.4 (−0.1 to 1.4). With the use of the EggNest Complete ERPD without a lead apron, annualized total effective doses are ≤1% of the recommended annual maximum for all positions. Conclusions Compared with standard shielding, ERPDs significantly lowered scatter radiation exposure to all members of the cardiac catheterization laboratory.
SN  - 2047-9980
ER  -