Artifacts in fluoroscopy and changes in radiation dose caused by heating blankets and insulating covers during simulated endovascular treatment

PURPOSE: We aimed to assess whether insulating covers and warming systems cause artifacts in fluoroscopy, and whether they alter the radiation dose. METHODS: Eight insulating and warming systems were wrapped around the phantom in order to obtain images in fluoroscopy, and to measure the absorbed and scattered radiation dose. A dosimeter, endovascular catheters, and stents were placed into a phantom. The other dosimeter was placed outside of a C-arm table, at the operator’s and anesthesiologist’s locations. RESULTS: Most of the insulating covers did not cause artifacts in the fluoroscopy and led to a significant decrease in both the absorbed and scattered radiation dose. The highest decrease in the absorbed dose was observed with metalized foil (− 2.09%; p = 0.001) and in the scattered dose with Helios cover (− 55%; p < 0.001). Only one heating system (Ready Heat combined with Hypothermia Prevention and Management Kit cover) caused significant artifacts and increased radiation up to 99% (p < 0.001). CONCLUSION: Thermal insulation may be maintained during X-ray-guided emergency endovascular procedures in trauma victims. Self-heating blankets should be replaced with another warming system.