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Session: Poster Session 1 (Even numbers)
Session starts: Thursday 26 January, 16:00
Presentation starts: 16:00

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Thijs van Deudekom (Technical University of Delft)

Abstract:
Introduction and objectives - Radiation dose during cardiac catheterisation interventions has been a topic of growing interest in interventional cardiology in recent years. As it has adverse impacts on both the patient and the medical staff, there is great interest in decreasing radiation exposure during these procedures. For instance, interventional cardiologists have a higher chance of developing cataracts, lens opacities, skin cancer and brain tumours. Radiation protection consists of active and passive components. The active component focuses on minimising radiation during surgery. Active protection strategies include routine and appropriate use of lead apparel, using techniques in reducing radiation use to the patient and thereby the operator, beam angulation and repositioning yourself in the room. Unfortunately, clinicians do not realise when they receive too much radiation and can deploy certain measures. In current care, there is often monthly feedback on how much radiation the person has received, instead of during or directly after procedures. Real-time dose monitoring is upcoming, however, several types of feedback are being offered to staff. In this review the effectiveness of different possible real-time feedback methods are compared. Results - Possible feedback mechanisms include sounds, a bracelet displaying radiation, a 2D computer graphic of the patient and table from the ceiling viewpoint, and a 3D augmented reality (AR) display with a real-time video feed of the intervention room. However, the most commonly used and most promising technique was a bar graph displayed on a screen for the operator to see. The current dose rate was displayed in colour bars, which increased in size and changed colour as the radiation thresholds changed. Discussion - Audible feedback also resulted in a partial radiation reduction. However, its standard use was not tolerated by the staff and appeared to be too distracting. Further development is necessary to provide better feedback with more specific instructions on how to optimally use the possible measure. For instance, how to place the lead screen or to increase the distance to the source. Ultimately, automation or robotisation would be the optimal solution, as the doctor could be at a distance and would receive minimal radiation.