WASHINGTON—New research simultaneously published today in JSCAI and presented at TCT 2026 reported low operator radiation exposure during endovascular procedures using the Rampart Guardian radiation shielding system. The findings support efforts to protect physicians and other operators from occupational radiation exposure without relying on heavy lead aprons.
The study, " Observed Lead-Free Radiation Exposure with the Rampart Guardian System during Endovascular Procedures ," evaluated radiation exposure among physicians performing fluoroscopy-guided procedures at U.S. and international institutions after installing the ceiling-mounted shielding system.
Physicians who perform fluoroscopy-guided procedures face occupational radiation exposure and musculoskeletal strain from wearing protective lead aprons. Shielding systems offer an alternative approach to radiation protection without requiring operators to wear lead aprons. Most procedures in this study also used supplemental under-table shielding and a flexible radiation-protection drape placed on the patient.
"Protecting physicians from radiation should not come at the expense of their musculoskeletal health," said corresponding author Eric A. Secemsky, MD, MSc, FSCAI. "These findings are encouraging because they document low operator exposure across a broad range of procedures and centers using a lead-free shielding approach. Further research will help establish how these results translate to routine practice without manufacturer-supervised setup or real-time radiation feedback."
The observational analysis included 1,222 procedures performed by 416 operators across 95 sites between September 2025 and June 2026. Of these, 1,208 procedures (98.9%) were performed with Rampart shielding. Radiation exposure was measured using dosimeters worn on the primary operator's left shoulder.
Across all procedures, 29.6% had operator radiation exposure below the dosimeters' detection threshold. Median operator exposure during coronary procedures was 1 microsievert. Electrophysiology procedures had the highest proportion of undetectable exposure (66.3%), while median exposure during aortic procedures was higher, at 10 microsieverts.
The study did not directly compare the system with traditional lead-apron shielding. Manufacturer representatives were present during all cases to optimize setup, and operators had access to real-time radiation measurements, which may have influenced procedural practices. Exposure was measured only at the left shoulder. Further research without real-time radiation feedback would help determine how the system performs in routine practice without active monitoring.
TCT 2026 Session Information
Session: Robotics and Cath Lab Radiation Safety
Date: Monday, November 2, 2026
Session Time: 8:00–9:00 a.m. PT / 11:00 a.m.–noon ET
Study Presentation: 8:10 a.m. PT / 11:10 a.m. ET
Location: Station 1
Abstract: TCT 589
https://www.tctconference.com/program-guide/146278/146282
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