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New research published in JSCAI and presented at TCT 2026 reports 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, M.D., M.Sc., 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. 9%) were performed with Rampart shielding. Radiation exposure was measured using dosimeters worn on the primary operator's left shoulder.

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