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Tag: No Brainer Surgical Cap

RADPAD-scatter-radiation-protectio
Radiation Exposure May Increase Alzheimer’s Risk– How Can You Stay Protected?

Radiation Exposure May Increase Alzheimer’s Risk– How Can You Stay Protected?

Posted on June 11, 2018 by in Uncategorized with no comments

June is National Alzheimer’s & Brain Awareness Month. More than five million Americans are living with Alzheimer’s, and deaths caused by the disease have increased by 89% since 20001. Clinical studies have shown that exposure to low and high doses of ionizing radiation can be a risk factor in developing Alzheimer’s2.

The RADPAD® from Worldwide Innovations & Technologies, Inc. is a sterile shield comprised of specially developed radiation attenuating material, clinically-proven to protect both physicians and patients from the harmful effects of scatter radiation during fluoro-guided procedures and CT scans. The RADPAD® works by absorbing scatter radiation that is projected from the patient, as well as creates a “shade zone” for cath lab personnel so they are protected during interventional procedures. (Insert the picture showing the “shade zone” by this paragraph)

The RADPAD® No Brainer®, an attenuation material-lined scrub cap, is worn by physicians in the cath lab to protect the brain from scatter radiation during fluoro-guided procedures.

The No Brainer

The No Brainer

The RADPAD® Body Guard Sets, which are wraps fitted for adults, children, and infants, contain a separate wrap to protect the patient’s brain during CT examinations.

The RADPAD® is also important for protecting both physicians and patients from the increased risk of cancer due to exposure to radiation. In a clinical study, results showed that cancer risks from radiation remain elevated by 24% even after 15+ years of the first exposure3.

For more information on the RADPAD®, contact your local MED Alliance Group Sales Representative, call 888-891-1200 or email us.

 

1 “2017 Alzheimer’s Disease Facts and Figures.” alz.org®, 2017, http://www.alz.org/facts/overview.asp.

2 Begum, Nasrin; Mori, Masahiko; Vares, Guillaume; Wang, Bing. “Does ionizing radiation influence Alzheimer’s disease risk?” US National Library of Medicine National Institutes of Health. vol. 53., no. 6, 2012, pp. 815-822.

3 Mathews JD, Forsythe AV, Brady Z, et al, Cancer risk in 680,000 people exposed to computer tomography scan in childhood or adolescence data linkage study of 11 million Australians. BMJ. 2013; 346:f2360.


CONTACT US

Send inquiries to info@radpad.com for a free No Brainer™ sample. The No Brainer™ blocks up to 95% of radiation exposure to the brain. Lightweight, adjustable protection for all O.R. suite and fluoro lab personnel during interventional procedures.

WORLDWIDE INNOVATIONS & TECHNOLOGIES, INC. (WIT)
14740 W 101st Terrace
Lenexa, KS 66215
Phone: 913-648-3730 or 1-877-7RADPAD (1-877-772-3723)
Fax: 913-648-0131
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x-ray-radiation-protection-sleeve
Scatter Radiation is Unavoidable, Physician Protection is Not

Scatter Radiation is Unavoidable, Physician Protection is Not

Posted on November 27, 2017 by in Products, Safety with no comments

Protecting Hospital Staff During Fluoro-Guided Procedures

Radiation Therapy is a powerful tool in medicine, especially when used to treat cancer. Radiation works by killing and slowing the growth of cancer cells – but it can also damage healthy cells in the process, which can increase the risk of developing cancer in the future.

In 2017, approximately 80,000 new cases of brain tumors are expected to be diagnosed, with roughly 26,000 of those being malignant cases.^1 This depicts brain and other central nervous system cancer as the 10th leading cause of death in both men and women, and an estimated 16,700 individuals are expected to die from primary brain cancer this year. ^2

 

RADPAD® Radiation protection Products

While healthcare providers are diligent in their efforts to keep patients safe from scatter radiation, it is also important for providers to consider their safety when performing these procedures. Scatter radiation is secondary radiation that deflects from an object, most commonly the patient, during procedures, and can affect the healthcare provider’s brain in the process.

RADPAD® from Worldwide Innovations & Technologies is a full line of radiation protection products that are dedicated to protecting hospital staff during fluoro-guided procedures.

The No Brainer

The No Brainer®

The RADPAD® No Brainer® is an attenuation material-lined scrub cap worn by cath lab personnel that protects the brain from scatter radiation during fluoro-guided procedures.

 

x-ray-protection-thyroid-collar

Thyroid Collar

 

The RADPAD® is also available as a thyroid shield and a full-length protection sleeve to cover the neck and arms of the physician during these procedures.

 

RADPAD-table-skirt

Table Skirt with Anchor

The RADPAD® Table Skirt anchors to the table in the cath lab to block scatter radiation that flows from below the table, and the RADPAD® Specialty Shields create a shade zone where the physician can work from.

To learn more about how you can protect yourself and your patients with the RADPAD®, contact us:

WORLDWIDE INNOVATIONS & TECHNOLOGIES, INC. (WIT)
14740 W 101st Terrace
Lenexa, KS 66215
Phone: 913-648-3730 or 1-877-7RADPAD (1-877-772-3723)
Fax: 913-648-0131

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1 http://www.abta.org/about-us/news/brain-tumor-statistics/?referrer=https://www.google.com/

2 http://www.cancer.net/cancer-types/brain-tumor/statistics

RADPAD Interventional Cardiology News: the EARLY TAVR Trial

RADPAD Interventional Cardiology News: the EARLY TAVR Trial

Posted on July 21, 2017 by in Procedures with no comments

The following article from Diagnostic and Interventional Cardiology  offers interesting news about the EARLY TAVR trial, and insights from Philippe Genereux, M.D., interventional cardiologist and the trial’s lead investigator.

The EARLY TAVR trial’s purpose is to assess any health benefit from replacing the aortic valve through a minimally invasive, catheter-based procedure prior to patients showing symptoms, as opposed to the standard of care of observing patients until symptoms develop.

 

FEATURE | HEART VALVE TECHNOLOGY | JULY 14, 2017

First Patient in World Enrolled in Study Evaluating TAVR for Asymptomatic Severe Aortic Stenosis

Morristown Medical Center randomizes first patient in the EARLY TAVR trial, which may change treatment paradigm to save heart function, prevent deterioration

Edwards Sapien 3 TAVR valve will be implanted in asymptomatic aortic stenosis patients in the EARLY TAVR Trial

July 14, 2017 — Morristown Medical Center, part of Atlantic Health System, has randomized the first patient in the world to the EARLY TAVR (Evaluation of Transcatheter Aortic Valve Replacement Compared to SurveilLance for Patients With AsYmptomatic Severe Aortic Stenosis) trial.

Philippe Genereux, M.D., an interventional cardiologist and co-director of the Structural Heart Program at the Gagnon Cardiovascular Institute at Morristown Medical Center, serves as the trial’s principal (lead) investigator. The study is a U.S. Food and Drug Administration approved inventigational device exemption (IDE) trial.

Traditionally, patients with severe aortic stenosis (AS)—a narrowing of the aortic valve in the heart that keeps it from opening fully—who do not yet have symptoms (asymptomatic), are regularly followed and monitored by their cardiologist, and treatment is not initiated until they become symptomatic. However, many elderly patients with asymptomatic severe AS can develop irreversible heart damage or even die while waiting for symptoms to appear. The EARLY TAVR trial will evaluate whether there is benefit from replacing the aortic valve via a minimally invasive, catheter-based procedure (called a transcatheter aortic valve replacement) before patients develop symptoms (shortness of breath, dizziness, fainting, or angina) as compared to the standard of care of watching the patient until symptoms develop.

“The EARLY TAVR trial is an incredibly important trial for the more than 2.5 million people who suffer from aortic stenosis because it may provide an answer to the frequent dilemma cardiologists face about how they should treat severe aortic stenosis, even though patients have no symptoms,” Genereux explained. “The progression of aortic stenosis is unpredictable, and there may be a price to pay for waiting to treat—the goal of early intervention with valve replacement is to preserve the heart’s function, prevent further heart deterioration, and in some case, death.”

“As a nationally recognized leader in cardiology and cardiovascular surgery, Atlantic Health System is committed to both prolonging and improving the quality of life for patients with heart disease,” said Linda D. Gillam, M.D., MPH, The Dorothy and Lloyd Huck Chair of Cardiovascular Medicine at Morristown Medical Center/Atlantic Health System. “Our participation in clinical trials, like EARLY TAVR, not only ensures our patients have access to new treatments before they are approved or available to the general public, but helps our clinicians remain on the cutting edge of medicine with access to the latest medications, devices, and technology.”

 

About the EARLY TAVR Trial

Evaluation of Transcatheter Aortic Valve Replacement Compared to SurveilLance for Patients With AsYmptomatic Severe Aortic Stenosis (EARLY TAVR) is a randomized, controlled, multi-center clinical trial study. Patients aged 65 and older diagnosed with asymptomatic, severe aortic stenosis will be randomized to receive a transcatheter aortic valve replacement (TAVR) with the Edwards Sapien 3 heart valve, or standard of care clinical surveillance. The study will enroll 1,000 patients in 65 cardiovascular centers.

Patients will be randomized (TAVR or surveillance) based on their ability to perform a treadmill stress test, as well as other factors. Those patients with a positive treadmill stress test or who do not meet other factors for randomization may be followed in a registry for data collection on subsequent treatment and mortality, as applicable.

The EARLY TAVR trial is sponsored by Edwards Lifesciences. According to Edwards Lifesciences, global transcatheter heart valve therapy (THVT) sales rose 29 percent to $432 million in the past year. In the United States, sales grew by 38 percent. Edwards said cardiac surgeons and interventional cardiologists are now implanting the company’s Sapien 3 TAVR devices at more than 500 hospitals in the U.S.

For more information: www.atlantichealth.org/valveresearch

CONTACT US

Send inquiries to info@radpad.com for a free No Brainer™ sample. The No Brainer™ blocks up to 95% of radiation exposure to the brain. Lightweight, adjustable protection for all O.R. suite and fluoro lab personnel during interventional procedures.

WORLDWIDE INNOVATIONS & TECHNOLOGIES, INC. (WIT)
14740 W 101st Terrace
Lenexa, KS 66215
Phone: 913-648-3730 or 1-877-7RADPAD (1-877-772-3723)
Fax: 913-648-0131
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Studies Support the Need for Radiation Protection for the Brain

Studies Support the Need for Radiation Protection for the Brain

Posted on May 12, 2017 by in Safety with no comments

Here we present the first of two studies regarding Rad Techs and brain cancer.  This study (3/25/2016) showed a 2.5 times greater incidence of brain cancer due to radiation exposure in the fluoro labs than to those RTs working outside the interventional suite. The study recommended ALARA and more work in this area.

This study and can be used to support the need for radiation protection for the brain.

See the original article publication here.
Read the full article below:
What’s the radiation risk to RTs from fluoro studies?

By Brian Casey, AuntMinnie.com staff writer

April 7, 2017 — Are radiologic technologists (RTs) who assist with interventional studies at higher risk of death from brain cancer? Maybe, but it’s not clear that radiation exposure is the reason why, according to a new study published March 28 in the American Journal of Roentgenology.

Researchers from a variety of institutions studied brain cancer death rates in a group of 110,000 radiologic technologists who participated in a longitudinal survey starting in 1981. While RTs who were involved in fluoroscopy had slightly higher brain cancer death rates than those who weren’t, the researchers found no relationship between the amount of radiation they were exposed to on the job and their risk of brain cancer death.

This led Cari Kitahara, PhD, of the U.S. National Cancer Institute, and colleagues to conclude that there may be other factors behind why interventional RTs have higher brain cancer rates. These could include exposure to developing chemicals used to process film or drugs and iodinated contrast agents used during fluoroscopy-guided procedures (AJR, March 28, 2017).

On-the-job exposure

A number of studies in recent years have examined the link between radiation exposure and cancer death rates in radiologic technologists, particularly interventional procedures due to their higher radiation levels compared to static studies. Researchers have focused on brain cancer mortality because interventional technologists wear lead shielding that protects other parts of the body from radiation, while the head is for the most part unprotected.

A March 2016 study by Rajaraman et al found that interventional technologists had a mortality risk from malignant intracranial neoplasms that was 2.5 times higher compared to RTs who never assisted with fluoroscopy procedures. The current study used the same cohort as the Rajaraman study, but it was designed to assess whether there was a relationship between brain cancer mortality rates and the amount of radiation technologists were exposed to during their work histories.

Kitahara and colleagues analyzed data from the U.S. Radiologic Technologists Study, which began in the 1980s with a cohort of 146,022 technologists who were working in the field at the time, some having started their careers as early as 1926. The technologists received four surveys between 1983 and 2014 that asked various questions regarding work history and practices, medical history, and other issues.

Kitahara’s group used data from technologists who responded to the first or second cohort surveys (or both); this consisted of 83,655 female and 26,642 male technologists. To be included in the study, estimates of annual and cumulative radiation doses to the brain must have been performed for the individuals.

Dose estimates were derived from badge measurements for 72% of the study cohort members between 1960 and 1997, as well as detailed work histories of procedures and protection practices from the first three cohort surveys. The researchers used historical data and dose estimates for the years before 1960 when dosimetry badges weren’t yet available.

Kitahara and colleagues then tracked various demographic characteristics, lifestyle factors, and medical and work histories, including a history of working with fluoroscopy-guided imaging procedures. Finally, they tracked the number of cases of brain cancer that occurred in the subjects.

Over a median follow-up period of 26.7 years, 193 technologists who assisted with fluoroscopically guided procedures died of malignant brain tumors, the researchers found. Individuals in the group had a cumulative mean absorbed brain dose of 12 mGy.

Like Rajaraman et al, Kitahara’s group found a higher relative risk of brain cancer mortality among technologists who assisted with fluoroscopy compared to those who didn’t. But the relationship was not as strong: The new study found that those who were exposed to fluoroscopy procedures had a relative risk of brain cancer mortality of 1.7 compared to technologists who didn’t do fluoroscopy. This compared to a risk of 2.5 in the Rajaraman research. (The Kitahara study followed technologists for an additional four years compared to the previous research.)

Their next question was whether the technologists who received a higher radiation dose experienced a higher rate of brain cancer mortality. The answer was no: Kitahara and colleagues found an excess relative risk for brain cancer mortality of 0.1 per 100 mGy of exposure, just slightly above the rating of 0 that would indicate no association.

“We found no evidence of a dose-response association between cumulative protracted occupational radiation and malignant intracranial tumor mortality,” they wrote.

The researchers noted that the statistical power of their study may have been too limited to identify a positive relationship between radiation dose and mortality, given the relatively small number of cancer deaths and the low range of estimated radiation dose.

But they also postulated that the higher rate of brain tumor deaths found in both the Rajaraman and Kitahara studies could be due to factors other than radiation in the work environment of technologists who assist with interventional radiology

For example, technologists assisting with fluoroscopy-guided procedures continued to perform photographic subtraction angiography in darkrooms through the 1980s, whereas technologists working with static radiographs stopped working with open film tanks in the 1960s, they noted. Film-processing chemicals have been associated with a wide range of health maladies.

Fluoroscopy technologists are also exposed to a variety of drugs and iodinated contrast agents at a higher rate than other RTs, although the authors pointed out that a connection between such chemicals and brain tumor development has not yet been established.

In the end, Kitahara and colleagues noted that their findings are in line with other studies on exposure to low and moderate doses of radiation, which have not established a link between exposure levels and brain cancer mortality in adults.

They advised additional studies in the future, such as examining the association between protracted radiation exposure and benign brain tumor incidence in the same cohort.


CONTACT US

Send inquiries to info@radpad.com for a free No Brainer™ sample. The No Brainer™ blocks up to 95% of radiation exposure to the brain. Lightweight, adjustable protection for all O.R. suite and fluoro lab personnel during interventional procedures.

WORLDWIDE INNOVATIONS & TECHNOLOGIES, INC. (WIT)
14740 W 101st Terrace
Lenexa, KS 66215
Phone: 913-648-3730
or 1-877-7RADPAD (1-877-772-3723)

Fax: 913-648-0131

Email: info@radpad.com

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WIT Wins Business Award: 25 Under 25®

Posted on February 10, 2017 by in Other Stories with no comments

Worldwide Innovations & Technologies, Inc. Has Won the 25 Under 25® Award

2016AwardsLookingDown_25U25

“Small businesses are a powerful, but often overlooked force in Kansas City,” said Kelly Scanlon, CEO of Thinking Bigger Business Media and the creator of 25 Under 25®.

“Together, these companies employ thousands upon thousands of people, deliver innovative products and services, and help support our government, schools, nonprofits and other public resources. Of course, most of our winners are too humble and too busy to brag about their contributions. But it’s a story that needs to be told. The 25 Under 25® Awards are proud to celebrate the important service of small businesses.”

 

About the 25 Under 25® Awards

As part of its 10-year anniversary celebration in 2002, Thinking Bigger Business Media Inc. launched the annual 25 Under 25® Awards to recognize 25 outstanding Kansas City businesses with under 25 employees.

Until the 25 Under 25® Awards, no formal recognition program existed in the Kansas City area that specifically targeted businesses with fewer than 25 employees. Yet this segment of business comprises the largest number of companies both locally and nationally, with roughly 83 percent of Kansas City area and 86 percent of businesses nationwide employing 19 or fewer employees.

With the establishment of the 25 Under 25® Awards program, small businesses are being recognized for the significant role they play in the Kansas City economy. The 25 Under 25® Awards program is not just about honoring individual businesses—it’s also about opening the public’s eyes to the economic, social and community impact of small businesses.

 

Honorees

December 7, 2016

Thinking Bigger Business Media is proud to announce the honorees of the 16th annual 25 Under 25® Awards—a group that represents the best of Kansas City’s small business community.

The awards are presented to 25 local businesses with fewer than 25 employees. An independent panel of judges consisting of area business leaders chooses the winning companies. Nearly 1,500 nominations were submitted. This year’s honorees include:

 

More info on the awards and the award reception here: https://ithinkbigger.com/events/25-under-25/

WORLDWIDE INNOVATIONS & TECHNOLOGIES, INC. (WIT)
14740 W 101st Terrace
Lenexa, KS 66215
Phone: 913-648-3730
or 1-877-7RADPAD (1-877-772-3723)

Fax: 913-648-0131

Email: info@radpad.com

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RAPDAD Scatter Radiation Shields Protection during Vascular Surgery

Posted on January 20, 2017 by in Products, Safety with no comments

RADPAD-scatter-radiation-protectio

When people go through vascular surgery, scatter radiation occurs. Scatter radiation was inevitable in the past. But with today’s new technology at our disposal, we can protect ourselves from scatter radiation and get results. The most prominent target for scatter radiation are the patients themselves and then the physicians who care for them. Let us look at the different ways we can avoid scatter radiation.

Interventional Peripheral Shields

Interventional Peripheral Shields are used during vascular surgery and cardiothoracic surgery. The shields provide the physician with added length that helps him work on the entire length. The shade is what comes handy and helps in avoiding scatter radiation. There are a lot of fluids used in this process and this is the reason why it is available in absorbent covering.

The shields provide excellent protection during AAA (Abdominal Aortic Aneurysm) and TAVR (Transcatheter Aortic Valve replacement) procedures. During these procedures the physician is required on both sides and thus the protection is also available on two sides.

Why do we need Protection from Scatter Radiation?

Is it inevitable? Why do we need protection against scatter radiation? The simple reason is that all radiation is harmful and there is more than one person present for a surgery. The nurses and the doctors along with the patient are potentially at risk. This is the reason why we need to have protection against scatter radiation.

And this is why RADPAD is inventing and manufacturing better shields that drastically reduce the radiation in every interventional procedure. It is available from 50% to 95% at 90kVp.

Some shields are designed specifically for absorbing radiation in certain zones. This helps in giving the physicians a place where they can safely work where the radiation won’t affect them at all.

Moreover, there are safety regulations for the doctors that state the radiation exposure to the doctors and other personnel should be as low as reasonably achievable (ALARA). This makes the use of RADPAD shields even more important in every operation theater.

So, now you know what kind of RADPAD shields can be used to protect a physician and their team from harmful scatter radiations. When everyone is protected, then surgeons can focus on what’s important; operating on their patients. Get these RADPAD shields for your company today.

TAVR-Radiation-Protection
One-Third of Patients With Low Flow Aortic Stenosis Do Not Improve With TAVR, Research Finds

One-Third of Patients With Low Flow Aortic Stenosis Do Not Improve With TAVR, Research Finds

Posted on October 27, 2016 by in Procedures with no comments

Aortic Stenosis, the narrowing of the aortic valve in the heart, causing restricted blood flow, is one of the most common and serious valve disease problems. A TAVR procedure is the best option for treating this disease, but recent studies have shown that approximately one-third of low flow AS patients continue to suffer with low flow AS after the procedure.

Read the full article on the Radpad blog below, or see the original publication here: http://www.cathlabdigest.com/content/One-Third-Patients-Low-Flow-Aortic-Stenosis-Do-Not-Improve-TAVR-Research-Finds

One-Third of Patients With Low Flow Aortic Stenosis Do Not Improve With TAVR, Research Finds

Patients who do not improve with TAVR are found to have worse clinical outcomes at one year

TAVR-Radiation-Protection

June 16, 2016 – Aortic stenosis (AS), the narrowing of the aortic valve in the heart which causes restricted blood flow, is one of the most common and serious valve disease problems. For patients with one type of AS — low flow — transcatheter aortic valve replacement (TAVR), a minimally invasive procedure which corrects the damaged aortic valve, is often the best option for restoring the heart’s normal pumping function. However, approximately one-third of low flow AS patients treated with TAVR continue to suffer persistent low flow AS even after the procedure, ultimately increasing their risk of death. Now, researchers from the Perelman School of Medicine at the University of Pennsylvania have examined this high-risk patient population to determine the cause of this persistent low flow AS and to evaluate their risk of dying during the year following the procedure. Their findings are detailed in a paper published in the Journal of the American Medical Association – Cardiology.

“There has been a lot of interest in these patients with low flow AS, as their surgical mortality is higher than other patients. TAVR is often a good option, but not all of them will be able to normalize flow following the procedure and these persistently low flow patients have a 60 percent higher rate of mortality at one year,” said Howard C. Herrmann, MD, FACC, MSCAI, John W. Bryfogle Professor of Cardiovascular Medicine and Surgery, and director of Penn Medicine’s Interventional Cardiology Program. “Low flow before TAVR is one of the most important predictors of mortality following TAVR, but it is one of the harder qualities to measure. This presents a challenge to properly treating patients with low flow AS, and can leave some patients at higher risk.”

To better understand the potential benefits of TAVR for low flow AS, researchers conducted an analysis of 984 patients with low flow AS from the PARTNER trial and continued access registry from April 2014 through January 2016. A baseline and follow-up echocardiogram, evaluation of post-TAVR hemodynamics — blood flow — and one year outcomes were assessed.

Through this analysis, researchers identified the large subgroup of patients who, following TAVR, failed to regain normal flow despite a successful procedure. In the first six months following TAVR, flow improved in roughly 66 percent of the patients evaluated. However, those with severe low flow AS had the highest mortality rate — 26 percent — at one year, as compared to approximately 20 percent for those with moderate low flow and even less for those with normal flow.

“Unfortunately, many centers do not routinely measure flow, but rather focus more on a patient’s pressure gradient or valve area when evaluating aortic stenosis pre-and post-TAVR,” said Herrmann. “While low flow is more challenging to monitor, this measurement can better inform the patient’s risk of mortality, and in turn lead to better treatment.”

The researchers noted that the identification of remedial, or treatable, causes of persistent low flow following TAVR, such as severe mitral regurgitation and atrial fibrillation, may represent an opportunity to improve the outcomes of these patients.

Journal Reference:

  1. Venkatesh Y. Anjan, MD; Howard C. Herrmann, MD; Philippe Pibarot, PhD; William J. Stewart, MD; Samir Kapadia, MD; E. Murat Tuzcu, MD; Vasilis Babaliaros, MD; Vinod H. Thourani, MD; Wilson Y. Szeto, MD; Joseph E. Bavaria, MD; Susheel Kodali, MD; Rebecca T. Hahn, MD; Mathew Williams, MD; D. Craig Miller, MD; Pamela S. Douglas, MD; Martin B. Leon, MD. Evaluation of Flow After Transcatheter Aortic Valve Replacement in Patients With Low-Flow Aortic Stenosis: A Secondary Analysis of the PARTNER Randomized Clinical Trial. Journal of the American Medical Association — Cardiology, June 2016 DOI: 10.1001/jamacardio.2016.0759
SCAI: Women Undergoing TAVR Have a Different Risk Profile and Greater Survival Rate Than Men

SCAI: Women Undergoing TAVR Have a Different Risk Profile and Greater Survival Rate Than Men

Posted on August 23, 2016 by in Other Stories with no comments

 

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Although women are more likely to experience vascular complications in the hospital, their one-year survival rate is more favorable than men. 11,808 women and 11,884 men were evaluated over two years and the one-year mortality rate was lower in women, although the in-hospital survival rate was about the same.

Read the full article below, or click the link to see the original posting:

http://www.cathlabdigest.com/content/SCAI-Women-Undergoing-TAVR-Have-Different-Risk-Profile-Greater-Survival-Rate-Men

SCAI: Women Undergoing TAVR Have a Different Risk Profile and Greater Survival Rate Than Men

May 6, 2016 — Orlando, Fla. – Data from one of the largest national registries of transcatheter aortic valve replacement (TAVR) patients shows that although women are more likely to experience vascular complications in the hospital, their one-year survival rate is more favorable than men. This STS/ACC TVT Registry™ analysis was presented today as a late-breaking clinical trial at the Society for Cardiovascular Angiography and Interventions (SCAI) 2016 Scientific Sessions in Orlando, Fla.

Investigators evaluated in-hospital and one-year outcomes for 23,652 TAVR patients, including 11,808 women (49.9 percent) and 11,844 men (51.1 percent), from 2012-2014. Compared to men, women were older, with lower GFR (kidney function) but higher prevalence of porcelain aorta and a higher mean STS adult cardiac surgery risk score (9 percent vs. 8 percent). However, women undergoing TAVR had a lower prevalence of comorbidities, such as coronary artery disease, atrial fibrillation and diabetes.

“Prior to this study, smaller analyses have suggested that men and women have different outcomes following TAVR procedures,” said Jaya Chandrasekhar, MBBS, MRCP, FRACP, a post-doctoral research fellow with Roxana Mehran, MD, FACC, FAHA, FSCAI, at the Icahn School of Medicine at Mount Sinai and the primary author of this report. “We wanted to gain in-depth understanding into the differences between men and women undergoing TAVR procedures from the US national registry and to evaluate the discrepancies by sex in longer-term outcomes.”

The study demonstrated that women were treated more often using non-transfemoral access (45 percent vs. 34 percent) with smaller sheath and device sizes but had a higher valve cover index than men. Post-procedure, women experienced more in-hospital vascular complications than men (8.27 percent vs. 4.39 percent, adj HR 1.70, 95 percent CI 1.34 – 2.14, P < 0.001) along with a trend for more bleeding (8.0 percent vs. 5.96 percent, adj HR 1.19, 95 percent CI 0.98 – 1.44, P = 0.08).

Despite these complications for women, the in-hospital survival rate was the same as men. Additionally, one-year mortality was lower in women (21.3 percent) than in men (24.5 percent).

“These findings are promising for women,” said Dr. Chandrasekhar. “There is a suggestion that the lower rate of coronary artery disease in women undergoing TAVR does put them at an advantage for longer-term survival, compared to men. The next step should be to study quality of life metrics and outcomes beyond one year including causes for death in both men and women. At the same time, frailty should be better defined to allow appropriate selection of patients for this procedure.”

Dr. Chandrasekhar reports no disclosures.

Dr. Chandrasekhar presented “Sex Based Differences in Outcomes With Transcatheter Aortic Valve Therapy: From STS/ACC TVT Registry” on Friday, May 6, 2016, at 9:00 a.m. ET.

For more information about the SCAI 2016 Scientific Sessions, visit www.scai.org/SCAI2016.

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About SCAI
The Society for Cardiovascular Angiography and Interventions is a 4,500-member professional organization representing invasive and interventional cardiologists in approximately 70 nations. SCAI’s mission is to promote excellence in invasive/interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. SCAI’s public education program, Seconds Count, offers comprehensive information about cardiovascular disease.

 

WORLDWIDE INNOVATIONS & TECHNOLOGIES, INC. (WIT)
14740 W 101st Terrace
Lenexa, KS 66215
Phone: 913-648-3730
or 1-877-7RADPAD (1-877-772-3723)
Fax: 913-648-0131
Follow RADPAD® on Facebook
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BRAIN Study Confirms Higher Radiation Dose to Cardiologists’ Left Side

BRAIN Study Confirms Higher Radiation Dose to Cardiologists’ Left Side

Posted on July 29, 2016 by in Safety, Uncategorized with no comments

BRAIN Study Confirms Higher Radiation Dose to Cardiologists’ Left Side:

This study was conducted by Ethisham Mahmud, MD, of University of California, San Diego, along with 7cardiology fellows and 4 physicians as they performed diagnostic and interventional cardiovascular procedures to show the attenuation of radiation by using a lead-free cap. Dr. Mahmud discusses the significant amount of exposure the left time of the cranium receives compared to the right during these procedures. Dr. Mahmud says that we need to do a lot more to further understand the equipment being used and the dangers of radiation in the lab. He notes that lead-free caps are a great way to reduce scatter radiation.

Contact us for a No Brainer surgical cap sample

 

Read the full article below or see the original piece here:

http://www.tctmd.com/show.aspx?id=130244

 

BRAIN Study Confirms Higher Radiation Dose to Cardiologists’ Left Side

Key Points:

  • Single-center study looks at whether protective cap can limit radiation exposure during interventional procedures
  • Exposure consistently greater on left side of head; secondary operators receive more radiation than primary

By Yael L. Maxwell
Tuesday, August 18, 2015

Radiation exposure to the cranium is higher on the left than on the right side for cardiologists doing invasive procedures, though this difference can be attenuated by wearing a nonlead-based cap in the cath lab, according to a study published in the August 17, 2015, issue of JACC: Cardiovascular Interventions.

Implications: BRAIN Study Confirms Higher Radiation Dose to Cardiologists’ Left Side

For the BRAIN (Brain Radiation Exposure and Attenuation During Invasive Cardiology Procedures) study, Ehtisham Mahmud, MD, of the University of California, San Diego (La Jolla, CA), and colleagues assessed 7 cardiology fellows and 4 attending physicians (mean age 38.4 years; all men) at their institution as they performed diagnostic and interventional cardiovascular procedures (mean 66.2 cases per operator; mean fluoroscopy time 14.9 minutes).

Each participant wore a lightweight XPF attenuating cap (BLOXR; Salt Lake City, UT) containing barium sulfate and bismuth oxide. All caps were fitted with 6 dosimeters to measure radiation exposure on the outside and inside of the cap.

A Little More on the Left

Total exposure on the outside of the cap was numerically higher on the left than center location (106.1 vs 83.1 mrad; P = .075), but exposure in both areas was higher than on the right side (50.2 mrad; P < .001 for both). Total exposure inside the cap was similar for all 3 locations—ranging from 41.8 to 42.3 mrad—and was only slightly higher than that measured by the ambient controls (38.3 mrad; P = .046).

After accounting for the ambient radiation, outside left exposure was 16 times higher than exposure on inside left and 4.7 times higher than that on the outside right (P < .001 for both). Exposure on the outside center was 11 times higher than on the inside center of the cap (P < .001), but no difference was seen between outside and inside doses on the right side.

Among a variety of factors—including patient weight, patient BMI, operator height, operator weight, percentage of radial cases, fluoroscopy time, and dose area product—only operator training level (fellow in training or attending cardiologist) predicted the extent of radiation exposure on the outside left and center locations.

Attending cardiologists—who tend to stand in the secondary position farther from the radiation source—received more outside left and center radiation than did fellows, who usually stand in the primary position (P = .002 and P = .01, respectively). “Despite the decreased exposure to the second operator as explained by the inverse square law, the optimal use of shielding in favor of the primary operator may overcome the protection offered by the increased distance,” Dr. Mahmud and colleagues suggest.

The Cap is Only the Beginning

In a telephone interview with TCTMD, Dr. Mahmud said the value of the study is “not as much about the cap as the concept.” Regardless of what protection operators may or may not use, “the most important message of this paper is that the left side of the brain gets tremendously greater exposure to radiation,” he said.

“We’re not doing a whole lot to protect ourselves… whether it’s in the primary or secondary position,” Dr. Mahmud continued. “One option is this cap, but the reality is we need to do a lot more to further understand and design equipment… or to look at alternative ways to do the procedure.”

Stephen Balter, PhD, of Columbia University Medical Center (New York, NY), told TCTMD in a telephone interview that the overall exposure reported outside the cap in the study is “reasonable” and well within the regulatory guidelines of 15,000 total mrad per year.

That said, using the cap “certainly doesn’t hurt,” he commented, and the fact that it can be used multiple times makes it less expensive than other options.

It is well known that radiation exposure is greater on the left than right side of cath lab operators, Dr. Balter explained. “It’s just how they stand and how they look at the monitors.” But “tracking people and understanding what’s happening is very relevant,” he said, adding that more specific results should come in time with theoretical modeling studies.

There will never be enough epidemiological research to show whether the XPF cap and other protections are increasing safety, Dr. Balter said. “There is a theoretical gain based on the radiobiology of models,” he added. “But it’s a small gain based on these numbers.”

All About Education

Dr. Mahmud said his team is planning another study, known as BRAIN 2, to further examine the phenomenon of how operator position affects radiation exposure. “The primary position is actually often better protected than the secondary position, where you’re a little bit further away but you might get more exposure to scatter,” he explained. “This is probably the first time this has ever been measured and ascertained.”

The second study will assess the validity of the difference between positions, Dr. Mahmud said. “We’re actually going to measure in a very systematic manner the radiation exposure for operators in the primary and secondary positions and behind and in front of shields.” BRAIN 2 will require the operators to stay in the same position throughout the course of each procedure, he explained.

But all of these studies, present and future, are meant to educate, Dr. Mahmud observed. “I am always shocked as to how few people seem to even admit that [radiation] is an issue. So I think it’s going to take more and more information, knowledge, and dissemination,” about the potential risk and any preventative options available, he said.

 


Source:
Reeves RR, Ang L, Bahadorani J, et al. Invasive cardiologists are exposed to greater left sided cranial radiation: the BRAIN study (Brain Radiation Exposure and Attenuation During Invasive Cardiology Procedures). J Am Coll Cardiol Intv. 2015;8:1197-1206.

Disclosures:

  • Dr. Mahmud reports receiving clinical trial support from Boston Scientific, Corindus, and Gilead; serving as a consultant to The Medicines Company; and serving on the speakers bureau of Medtronic.
  • Dr. Balter reports no relevant conflicts of interest.

 

 

 

Protecting the Provider:  A Reexamination of Cath Lab Radiation Safety

Protecting the Provider: A Reexamination of Cath Lab Radiation Safety

Posted on July 22, 2016 by in Safety with no comments

Protecting the Health of Cath Lab Technicians

Unlike patients who are only exposed to ionized radiation during their procedure, cath lab technicians are exposed during every procedure they perform. This article discusses health effects associated with radiation exposure in the cath lab along with ways to protect the health of those technicians. Two of those ways are wearing a lead-based shield, and keeping a distance between the operator and the radiation source.

Wohns, David, and Ryan Madder. “Protecting the Provider: A Reexamination of Cath Lab Radiation Safety.” Cath Lab Digest. HMP Communications, Feb. 2015. Web. 26 May 2016.

Read the article in full below, or click the link to see the originally published article at Cath Lab Digest:

http://www.cathlabdigest.com/article/Protecting-Provider-Reexamination-Cath-Lab-Radiation-Safety

 


 

Protecting the Provider: A Reexamination of Cath Lab Radiation Safety

Author(s):

David Wohns, MD, Medical Director, and Ryan Madder, MD, 

Kresge Cardiac Cath Labs, Frederik Meijer Heart & Vascular Institute, 

Spectrum Health, Grand Rapids, Michigan

Topics:
Radiation
Safety
Robotic PCI

In the delivery of high-quality healthcare, patient safety is always a major concern of providers and the public. The safety of healthcare workers frequently receives significantly less attention. Recent events have highlighted this issue and are altering this perspective, with greater recognition of the sacrifices and risks that healthcare workers routinely take to perform their jobs. Patient safety remains the number-one concern of healthcare providers. However, the health and safety of providers should receive equal attention, particularly when novel techniques and strategies can be adopted to mitigate provider risk.

During 2014, the Ebola patients treated within U.S. borders caught the attention of the mainstream media and the public. Besides the public’s general concern for the patients, much attention was devoted to the healthcare workers who were exposed to the virus while caring for Ebola patients. These events raised the public’s awareness of healthcare worker safety and also caused many people to ask: “How do we ensure the safety of healthcare providers who put themselves in harm’s way to look after their patients’ health?

Madder

This increased awareness is especially relevant to interventional cardiologists. Unlike patients, who are only exposed to ionizing radiation during their procedure, interventional cardiologists and other members of the cath lab team are repeatedly exposed to ionizing radiation, subjecting them to potentially serious long-term health issues. Additionally, the physical demands of performing their jobs while wearing heavy protective gear can lead to chronic orthopedic conditions that may prematurely end careers or force change into other fields of medicine.

Wohns

With the increased interest in healthcare worker safety, it is an appropriate time to explore the risks associated with cath lab environments and novel technological solutions available to improve safety.

Assessing cath lab risks

Medical procedures performed in the cath lab are a leading source of occupational ionizing radiation exposure for medical personnel1, due to the use of fluoroscopy and cine angiography during these procedures. This occupational radiation exposure is of particular concern because today’s interventional cardiologists are spending significantly greater time in the cath lab doing more complex and lengthy procedures. Further, the performance of percutaneous coronary intervention (PCI) procedures in cath labs has increased more than 50 percent since 20002, potentially exposing interventional cardiologists to additional radiation.

Although research studies have demonstrated substantial variations in the amount of ionizing radiation to which interventional cardiologists are exposed, a look at the literature reveals the following:

  • One study showed that an interventional cardiologist’s head and neck area are generally exposed to approximately 20 to 30 millisieverts (mSv) per year3, which equates to 2 to 3 rems per year.
  • Another demonstrated that cumulative doses for the average interventional cardiologist after 30 years in the cath lab fall between 50 to 200 mSv, equivalent to 5 to 20 rems, or 2,500 to 10,000 chest x-rays.4
  • A third shows that interventionalists receive approximately 1 to 3 sieverts (Sv) to their head during their career (equivalent to 1,000 to 3,000 mSv, or 100 to 300 rems), which corresponds to about 500mSv to the brain5 (equivalent to 50 rems).
  • A separate study showed that interventional cardiologists have a radiation exposure rate documented to be two to ten times higher than that of diagnostic radiologists.4

 

Adverse health effects

Despite the availability and use of personal protective equipment (PPE), such as lead aprons, leaded glasses and thyroid collars, there are significant radiation exposure risks that have the potential to negatively impact the health of interventional cardiologists and their staff. Below are some findings from recent scientific literature:

  • Cataracts: The Occupational Cataracts and Lens Opacities in Interventional Cardiology (O’CLOC) study revealed that 50 percent of interventional cardiologists and 41 percent of cardiac cath nurses and technologists had significant posterior subcapsular lens changes, a precursor to cataracts, which is typical of ionizing radiation exposure.6
  • Thyroid disease: Studies have reported structural and functional changes of the thyroid as a result of radiation exposure.7 Structural changes such as malignant and benign thyroid tumors develop at a linear rate to dose exposure. Functional changes that would result in hyper- or hypo-thyroidism were noted at elevated doses of external and internal radiation exposure.7
  • Brain tumors and brain disease: A recent study focused on interventionalists who had been diagnosed with a variety of brain tumors. The study revealed that 86% of the brain tumors (where location is known) originated on the left side of the brain.8 This is significant, since interventional cardiologists typically stand with the left side of their body closest to the X-ray source and scattered radiation. In the general population, brain tumors originate with equal frequency on the left and right hemispheres.
  • Cardiovascular changes: Recent studies suggest evidence of a link between low- to moderate-dose radiation exposure and cardiovascular changes, despite personal protective wear.5
  • Reproductive health effects: For males, ionizing radiation has demonstrated a reduction in sperm.9 Additionally, cath lab staff members who may become pregnant while working in the cath lab must also take into consideration the effects that ionizing radiation can have on the developing fetus.

Additionally, there are orthopedic-related consequences from the heavy weight of lead gear worn by interventional cardiologists. The repeated standing and leaning over patients during procedures is fatiguing and commonly leads to chronic orthopedic conditions. A 2006 survey conducted by the Society for Cardiovascular Angiography and Interventions (SCAI) disclosed that interventional cardiologists suffer from a disproportionate amount of back, hip, and knee injuries leading to a significant amount of missed workdays.10 The weight of the personal protective gear is fatiguing, and a physician who is fatigued or experiencing discomfort may be more likely to be distracted or rush through a procedure.

Protecting the health of cath lab employees

There are two traditional techniques used to reduce radiation exposure. One is lead-based shielding, and the second is increasing the distance between the operator and the radiation source.

A relatively new approach to shielding includes devices that support lead aprons that hang from a boom, rather than being worn by clinicians. These hanging aprons provide effective radiation protection with a greater quantity of lead than is traditionally worn by operators. Since the operator is not physically supporting the lead, these devices have the potential to reduce orthopedic injuries and reduce overall operator fatigue.

The advent of robot-assisted percutaneous coronary intervention (PCI) represents another novel approach to reducing radiation exposure to operators. Robotic systems for PCI allow interventional cardiologists to perform procedures remotely, away from the patient’s bedside. Seated in a radiation-protected cockpit, the physician uses digital controls to robotically manage catheters, guide wires, angioplasty balloons, and stents to clear blockages and restore blood flow. These technologies are beneficial in reducing exposure by positioning operators further from the radiation source, but also have the potential to mitigate the impact that wearing PPE has on operators, such as orthopedic pain, missed work and disability.

The robotic-assisted PCI system being used at Spectrum Health is called CorPath (Corindus Vascular Robotics). The CorPath System allows physicians to perform PCI procedures from the comfort of a radiation-shielded cockpit that includes angiographic and hemodynamic monitors. Physicians using the system are able to take measurements, with sub-millimeter accuracy, of relevant anatomy, as well as advance or retract guide wires and/or balloon stent catheters with movements as small as a millimeter. A clinical trial has shown that using the robotic system reduced radiation exposure to the primary operator by more than 95 percent.11

Elevating healthcare worker safety

Interventional cardiology is a uniquely rewarding, highly innovative profession. The bulk of the innovation in our field over the past 3 decades has appropriately been focused on patient care. However, the manner and circumstances with which that care has been delivered in the cath lab has changed little over time. New approaches are now available to begin to mitigate the biomechanical, orthopedic, and radiation risks of working in the cath lab. The CorPath System is an example of a device with tremendous promise to reduce these hazards for interventional cardiologists, contributing to longer, healthier careers. We have been excited to bring this innovative technology to our cath labs as part of the evolution of our environment.

References

  1. Sun Z, AbAziz A, Yusof AK. Radiation-induced noncancer risks in interventional cardiology: optimisation of procedures and staff and patient dose reduction. Biomed Res Int. 2013; 2013: 976962. doi: 10.1155/2013/976962.
  2. Best PJ, Skelding KA, Mehran R, Chieffo A, Kunadian V, Madan M, et al; Society for Cardiovascular Angiography & Interventions’ Women in Innovations (WIN) Group. SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel. Catheter Cardiovasc Interv. 2011 Feb 1; 77(2): 232-241. doi: 10.1002/ccd.22877.
  3. L Renaud. A 5-y follow-up of the radiation exposure to in-room personnel during cardiac catheterization. Health Phys. 1992 Jan; 62(1): 10-15.
  4. Picano E, Andreassi MG, Piccaluga E, Cremonesi A, Guagliumi G. Occupational risks of chronic low dose radiation exposure in cardiac catheterisation laboratory: the Italian Healthy Cath Lab study. EMJ Int Cardiol. 2013; 1: 50-58.
  5. Picano E, Vano E, Domenici L, Bottai M, Thierry-Chef I. Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure. BMC Cancer. 2012 Apr 27; 12: 157. doi: 10.1186/1471-2407-12-157.
  6. Vano E, Kleiman NJ, Duran A, Romano-Miller M, Rehani MM. Radiation-associated lens opacities in catheterization personnel: results of a survey and direct assessments. J Vasc Interv Radiol. 2013 Feb; 24(2): 197-204. doi: 10.1016/j.jvir.2012.10.016.
  7. Ron E, Brenner A. Non-malignant thyroid diseases after a wide range of radiation exposures.Radiat Res. 2010 Dec; 174(6): 877-888. doi: 10.1667/RR1953.1.
  8. Roguin A, Goldstein J, Bar O, Goldstein JA.  Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol. 2013 May 1; 111(9): 1368-1372. doi: 10.1016/j.amjcard.2012.12.060.
  9. Burdorf A, Figà-Talamanca I, Jensen TK, Thulstrup AM. Effects of occupational exposure on the reproductive system: core evidence and practical implications. Occup Med (Lond). 2006 Dec; 56(8): 516-520.
  10. Dehmer GJ. Occupational hazards for interventional cardiologists. Catheter Cardiovasc Interv. 2006 Dec; 68(6): 974-976.
  11. Weisz G, Metzger DC, Caputo RP, Delgado JA, Marshall JJ, Vetrovec GW, et al. Safety and feasibility of robotic percutaneous coronary intervention: PRECISE (Percutaneous Robotically-Enhanced Coronary Intervention) Study. J Am Coll Cardiol. 2013 Apr 16; 61(15): 1596-1600. doi: 10.1016/j.jacc.2012.12.045.

Disclosure: Dr. Wohns and Dr. Madder report no conflicts of interest regarding the content herein.

The authors can be contacted via David.Wohns@spectrumhealth.org.

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