Techniques in vascular and interventional radiology
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Many interventionalists face physical challenges almost daily for years or decades. The burden of assuming awkward positions while carrying extra weight can take its toll on the musculoskeletal system to such an extent that the career is ended or modified to exclude procedural aspects. The proliferation of lighter aprons has unfortunately resulted in reduced protection with poor correlation of protection to labeling due to the inadequacies of testing methods for nonlead materials. ⋯ The suspended personal radiation protection system is a recent development which provides substantially greater radiation protection than conventional lead aprons combined with other shields, while also taking all of the weight off of the operator. It is composed of an expansive and thick (1mm Pb equiv) apron with a large face-shield to protect the neck, head, and eyes, and is suspended overhead to provide motion in the x, y, and z planes. Exposures may also be substantially reduced by leaving the area during acquisition sequences and use of power injectors.
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Medical staff should not be exposed to the primary X-ray beam during fluoroscopy-guided interventional procedures (FGIP). The main source of staff exposure is scatter radiation from the patient, which can be significant. Although many aspects of X-ray exposure to the patient as well as occupational exposure to interventional radiologists and other staff are strongly regulated and monitored in most countries, it is surprising how loosely the labeling and testing of the protective aprons is regulated. ⋯ Each interventionist should choose garments that are appropriately protective for that individual's practice. Review of past personal dosimetry results and consultation with a medical physicist can help the IR make the best decision. This article will help the reader to understand why all protective garments are not created equally, and provides some practical tools that will allow safe and healthy practice in FGIP.