With radiation exposure standards tightening up, any technology that drops dosimeter numbers without interfering with standard cath lab procedures is welcome indeed. Naturally, the ideal innovation would improve efficiency and patient safety at the same time.
In the three-room, high-volume cath lab of Bon Secours St. Francis Health System in Greenville, South Carolina [See CLD’s feature cath lab this month], a highly experienced team of technologists and nurses have developed the Cardio-TRAP (Cardiovascular Trans-Radial Access Platform) system. The foundation consists of a Base Board that attaches to the cath table by Velcro and remains in place between procedures. A radiation Shield quick-attaches vertically to the baseboard between the patient’s torso and right arm, and covers the area between the patient’s armpit and upper thigh. The Shield is 11 inches tall and, like all attachments, allows a full range of C-arm positions. Embedded in the Shield is a sheet of lead 1.0 mm thick, which absorbs more than 95% of incident radiation. The cardiologist and assistant are then exposed only to scatter radiation coming from outside the Shield coverage area. All other components are made of radiolucent, high-density polyethylene (HDPE), allowing clear and normal fluoroscopy. HDPE is as transparent to X-rays as clear glass is to light.
With proper setup and positioning, physician head exposure has been shown to decrease by an average of 60-70% or more. The system has been proven through thousands of procedures to not only reduce staff radiation exposure, but also to improve efficiency and patient safety. In addition to Bon Secours St. Francis, the system is in wide use in cath labs in the U.S. and as far away as Ahmedabad, India, where a peer-reviewed study is now underway to quantify the radiation reduction value of the Cardio-TRAP in a high-volume cath lab. Early results from this lab show a reduction in physician head exposure of 64%.
Also quick-attached to the Base Board, the Right Radial Base provides patient right arm support and a generous work surface. The Right Radial Base is elevated slightly to be level with the top of the table mattress. For left radial access, right-room operation cases, a Left Radial Base quick-attaches to the left of the Base Board to provide firm support of the patient’s left arm at the elbow, while the forearm rests across the upper abdomen. The Shield, Right Radial Base, and Left Radial Base (if used) are removed after each procedure, to be re-attached in under 15 seconds as the next patient is prepped. The entire system is non-sterile, and remains beneath the standard sterile draping and can be sanitized with any disinfectant.
We believe the system should easily pay for itself in less than a year, notably in those cath labs that now use disposable shielding. A range of accessories include a left radial artery access board, femoral access shield, physician arm rest, and wall storage hanger. The team also developed the Rad-Guard, an IV pole-mounted radiation shield designed to provide protection for circulating staff in the most hazardous areas of the cath lab.
For more information, visit
www.cardiotrap.com or contact Trans-Radial Solutions LLC at