Safety, functionality, or comfortability, what would you prefer? Most would argue safety without a doubt. Nevertheless, why should you have to choose? The benefits of Endovascular interventions are immense. For patients, less invasive procedures, for Society; more convenient due to reduced healthcare costs since shorter recovery time. However, for medical practitioners, it may mean a deteriorating working environment and increased exposure to harmful radiation, which potentially may result in radiation-induced diseases such as cancer.1,2,3
The foundation of change
Petra Apell M.Sc. and Fredrik Gellerstedt Tech.Lic., both became aware of the problems associated with radiation protection garments through their professional work relations. Historically, healthcare staff only had to wear protective garments for a short while, but Endovascular interventions have flourished over time. Wearing radiation protection garments for long periods has become the norm. It became evident that protective garments had not undergone the same rapid advancement of development as medical procedures. Based on this, the innovation company Texray (formally known as Ten Medical Design) was founded.
The design process began with how to make radiation protection garments more comfortable, with extended ergonomic properties. Perhaps they could be made of a woven textile material to maximize your comfort and pliability without jeopardizing radiation safety? After years of study, together with researchers at various universities and university hospitals, the first prototype textile came to life; NAFT (today called Texray and patented worldwide).
NAFT demonstrated unique qualities that would enable the manufacturing of more comfortable and ergonomic radiation protection garments than the traditional lead shields available on the market. Texray now had its first patent – a unique textile constituted of a woven material with a breathable capability with attenuating capacity that meets the highly demanding global radiation protection standards (IEC 61331-1/3: 2014) to protect you from harmful radiation. After testing the textile at numerous clinics in Europe and completing folding tests in the Bally Leather Flexing Tester (ASTM D6182-00 (2015)); Texray (NAFT) also showed tremendous results on being 30 times more durable, compared to commonly used radiation protection materials. After 300,000 cycles, Texray only had occasionally cracked warp threads, but the weave still contained the fabric’s structure. The more commonly used radiation protection equipment indicated the first signs of damage after only 5,000 cycles; crack initiations were seen after 10,000 cycles, and 1mm-sized holes were noted at 25,000 cycles.5 With such a hole created, it is a matter of time before a tear propagates that may seriously reduce radiation protection.
Without a doubt, results meant that Texray potentially could serve as a more comfortable solution and also in some aspects, perhaps could be a safer choice (this is in regards to and emphasizing that tears cannot be noticed through the surface of protective garments. Hopefully, tears are detected in annual quality testing of the garments and replaced)?
Comfortability, as important or equal to ‘protected’?
To mitigate the risk of radiation exposure and the dosage of scatter radiation amongst medical staff performing Endovascular interventions, the use of glasses, leaded aprons, and thyroid protection are mandatory (locally, it might differ). However, your legs, arms, neck, and cranium are not fully protected if not using properly placed shields and additional garments.
In 2017, a head cap prototype with a unique design based on the validated radiation protective textile Texray was presented. The active choice of producing a head cap was based on a request; - "We need comfortable, safe and functional head protection," from international healthcare professionals, after being introduced to Texray textile. The head cap was subjected to functionality testing in a clinical environment, resulting in overwhelming numbers that concluded 100% of the respondents experienced great functionality, usability, and comfort of the head cap - now known as HeadPeace6. A functionality study was to follow, and as expected, results showed that HeadPeace significantly reduced the radiation dose to body parts that are currently not protected. Consequently, results meant that HeadPeace had the potential to improve the working environment for operating staff by further reducing radiation exposure and due to the positive results on functionality and comfortability tests.
Staying true to our concept and end-users
With a patented material and one commercialized product, widely used by medical practitioners looking to reduce their radiation exposure, Texray submitted the second product design to the collection of protective garments. Given the name MindPeace, a thyroid collar with the unique design (patent pending) of an extended panel, reducing radiation exposure coming from oblique below, passing through the lower and middle sections of the head. The idea behind this unique design was yet again based on close collaboration with end-users, seeking innovative radiation protection that would not have effects on patients nor their health. In 2019 a phantom study to measure the reduction of radiation exposure of Texray's novel product collection, HeadPeace, and MindPeace, was conducted. The result showed a significant reduction of radiation exposure with the use of Texray products and at this time at the extent of an additional 74% compared to using a standard thyroid collar. 8 HeadPeace and MindPeace where show-cased and clinically used during a live-procedure at LINC 2020.
The emerging global need for personal protection equipment
With the latest trending need to improve a safe working environment for healthcare professionals and patients, the concerns may also lie in the lack of proper, comfortable, and functional personal protection equipment. When we started the journey of Texray, our vision was clear; you, a medical practitioner, should not need to risk or worry about your health while saving the lives of others.
For this reason, we invented Texray, the first radiation protection textile in the world. It has to reduce ionizing radiation, and it must be comfortable, to the extent that it will not jeopardize your safety, both short and long-term.
Comfort is a safety factor too, so think ahead - and put - not only patient safety first but also your own.
1. Venneri L., Rossi F., Botto N., Andreassi MG., Salcone N., Emad A., Lazzeri M., Gori C., Vano E., Picano E. Cancer risk from professional exposure in staff working in cardiac catheterization laboratory: insights from the National Research Council’s Biological Effects of Ionizing Radiation VII Report. Am Heart J 2009;157:118e124.9. 2. Klein LW., Miller DL., Balter S., Laskey W., Haines D., Norbash A., Mauro MA., Goldstein JA. Joint Inter-Society Task Force on Occupational Hazards in the Interventional Laboratory. Occupational health hazards in the interventional laboratory: time for a safer environment. Radiology 2009;250:538e544. 3. Roguin A., Bartal G. Radiation and your brain. Endovascular Today, 2016, 15, 63-65. 4. Bjersgård A., En studie på strålskyddskläder, dess användning och användarnas rörelsemönster med ett ergonomiskt perspektiv. Centre for Health Technology Halland (HCH), Halmstad University, Sweden, 2015. 5. On file - Contact Fredrik Gellerstedt, Texray AB, for further information 6. Larsson M., Jonasson P., Apell P. Evaluation of a new personal radiation protection device for the operator’s head during X-ray diagnostics and interventions. Physica Medica, European Journal of Medical Physics, 2018, 52:84. 7. Larsson M, Apell P, Jonasson P, Lundh C. Evaluation of a novel thyroid collar designed to reduce head and neck radiation exposure during X-ray guided interventions. Poster presentation at the LINC meeting, Leipzig, Germany, 2020