Study Reports Low Operator Radiation Exposure With Rampart Guardian System

November 4, 2026—An observational study evaluating operator radiation exposure during endovascular procedures with the Rampart Guardian shielding system was presented at TCT 2026 and simultaneously published in JSCAI. The multicenter analysis showed low operator radiation exposure across several procedure types.

The study, “Observed Lead-Free Radiation Exposure With the Rampart Guardian System During Endovascular Procedures,” included 1,222 procedures performed by 416 operators at 95 United States and international sites between September 2025 and June 2026. Rampart shielding was used in 1,208 procedures (98.9%).

According to a press release provided by the Society for Cardiovascular Angiography & Interventions (SCAI), the analysis assessed exposure after institutions installed the system as an alternative to operator-worn lead aprons. Most procedures also incorporated supplemental under-table shielding and a flexible radiation protection drape placed on the patient.

Dosimeters worn on the primary operator’s left shoulder recorded exposure. Across all procedures, 29.6% had readings below the dosimeters’ detection threshold. Median operator exposure was 1 mSv during coronary procedures and 10 mSv during aortic procedures. Electrophysiology procedures had the largest proportion of undetectable readings at 66.3%.

“Protecting physicians from radiation should not come at the expense of their musculoskeletal health,” commented corresponding author Eric A. Secemsky, MD, MSc, FSCAI, in the press release. “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 investigators noted several limitations. Manufacturer representatives attended every procedure to optimize system setup, and operators could view radiation measurements in real time, potentially influencing their practices. Measurements were limited to the left shoulder, and the study did not include a direct comparison with conventional lead apron shielding.

Further evaluation without manufacturer-supervised setup or real-time radiation feedback is needed to assess performance under routine clinical conditions, according to the press release.