Interventional Radiology and Gloves

["Michael P. Grissom" <MIKEG%SLACVM.bitnet@vmd.cso.uiuc.edu>]

1.  The issues of gloves in the cardiac catheterization lab, in
particular, is a very delicate one.  There is no question that
relatively heavy gloves can help in high level fluorscopic GI
examinations requiring in-beam manipulations/maneuvers by the
attending physician.  However, in the cardiac "cat" lab, the
ply of the glove necessary for real protection can have a severe
impact on the outcome of the interventional activity.  After
all, a CAD patient that already has enough hardening of the
arteries to require interventional radiography has very little
vessel flexibility (due to wall stiffening) which helps account for
the relatively high morbidity (catheters through coronary
artery walls don't allow for much recovery time!) still seen in the
procedures.

2.  As I recall, a calculation of the relatively thin ply glove
(which strongly limits the Pb thickness equivalent) still
useful for the physicians to maintain the desired "feel" meant
that skin dose actually increased wearing the gloves due to
electron build-up!  Consequently, the use of shadow shields
attached to the heads (multiplanar devices now in use have two
or more x-ray tubes), wearing of aprons with thyroid shields, and
monitoring extremity dose (TLD on collar for lens of eye dose--
leaded glasses can help there too, of course) are the first order
approaches.  By the way, the gamma knife procedure (actual patient
radiation injuries have been reported due to the long beam on
times) has been a great concern at many university hospitals over
the last few years and is an area you may want to look very
closely at.
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The opions expressed above are those of the author alone and do not
not represent those of the Stanford University or the US Department
of Energy.
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