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Studies, figures and sources

The evidence for EggNest®

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Operator dose per case
0.01
EDE-1 dose per case with EggNest Complete in real-world published study20
Assistant dose per case
0.00
EDE-1 dose per case with EggNest Complete in real-world published study20
Nurse dose per case
0.00
EDE-1 dose per case with EggNest Complete in real-world published study20
All positions would receive
<1%
of the annual maximum (5000 mrem)20

The short answer

Does EggNest reduce scatter radiation?

Yes, confirmed in peer-reviewed, published studies. The estimated annual collar dose for primary operators dropped from 86.7 mrem with standard shielding to 25.5 mrem with EggNest Complete (p < 0.001). Pairing EggNest ERPDs with ultralight (0.125 mm) aprons yielded significantly lower annualized radiation doses than wearing traditional heavy (0.5 mm) aprons with standard shielding. The primary operator received an annualized EDE-1 dose of 51.4 mrem under 0.5 mm lead aprons with standard shielding vs. 1.4 mrem under 0.125 mm lead aprons with EggNest Complete (p < 0.001).20

Dose per case, by role

EDE-1 dose per case with EggNest Complete in real-world published study.

Operator
0.01
Assistant
0.00
Nurse
0.00
EDE-1 dose per case
RoleEggNest Complete
Operator0.01
Assistant0.00
Nurse0.00

What the figure says: all positions would receive <1% of the annual maximum (5000 mrem).20

Go deeper

Three ways into the evidence.

  • Society guidance

    ALARA+

    The ALARA+ summit and the multi-society consensus statement, what each asks of an interventional lab, and how to evaluate an ERPD against the statement's criteria.

    Go to ALARA+
  • The papers

    Articles and data

    Every published paper and presented abstract on EggNest, as documents you can read and share.

    Go to articles and data
  • In their words

    From the experts

    Physicians and lab staff who work with EggNest, on video and in their own words.

    Go to from the experts

Each study with key figures and where to find it.

Numbers in the dark squares match the reference list in the footer.

Peer-reviewed studies of EggNest
4
AHJ Plus 2025 and 2026, JSCAI 2025, JAHA 2026
Abstracts presented
14
PCR, TCT, CRT, ICI, SCAI, Veith, HPS and Western Vascular Society, 2018 to 2026
Studies in progress
6
across multiple specialties

Peer-reviewed studies of EggNest

Papers in peer-reviewed journals that measure EggNest directly.

  • 20

    Evaluating standard shielding versus novel enhanced radiation protection devices in the cardiac catheterization laboratory

    Guddeti RR, Schmidt CW, Riley RF, Kamen J, et al. J Am Heart Assoc. Published online 10 October 2026

    • 86.7 to 25.5 mremestimated annual collar dose for the primary operator, standard shielding to EggNest Complete20

    In 135 real-world coronary cases, EggNest Protect and EggNest Complete both lowered scatter to the primary operator, the assistant and the circulating nurse compared with standard shielding. With EggNest Complete, each position’s annualized effective dose was 1% or less of the annual maximum.20

    Method and full results
    What it measured
    Radiation dose to the primary operator, the scrub assistant and the circulating nurse in 135 elective and urgent coronary angiography and PCI cases at The Christ Hospital, Cincinnati, allocated in sequence to standard shielding (24), EggNest Protect (62) or EggNest Complete (49). Real-time dosimeters at five points on each person, over and under the apron; annual figures assume 300 cases a year. Cases with EggNest were run with standard 0.5 mm and light 0.125 mm aprons.
    What it found
    Collar dose per case was lower with both EggNest systems at every position (p ≤ 0.003). With EggNest Complete, light 0.125 mm aprons and standard 0.5 mm aprons gave no significant difference in annualized dose, and both were below standard shielding with standard aprons. Coronary cases only, at one center; STEMI and emergency cases were excluded.20
    Estimated annual collar dose, mrem, median, 300 cases a year20
    PositionStandardProtectComplete
    Primary operator86.759.325.5
    Assistant62.116.19.8
    Circulating nurse26.68.910.2
    Annualized effective dose (EDE-1), mrem, median, 300 cases a year20
    PositionStandardProtectComplete
    Primary operator51.47.02.4
    Assistant2.81.10.8
    Circulating nurse1.51.50.8
    Read the paper
  • 16

    Incorporating an enhanced radiation protection device into the treatment of ST elevation myocardial infarctions: a single center retrospective analysis

    Hutchings J, Mai E, Blay SP, Ballinger C, Riley RF. Am Heart J Plus. 2026;68:100816

    No significant difference in door-to-balloon time, and no meaningful delay in any individual step.16

    Method and full results
    What it measured
    Door-to-balloon time, and each step within it, for 133 consecutive STEMI patients treated with primary PCI at one tertiary center from July 2024 to December 2025: 71 in the cath lab with EggNest Complete, 62 in two labs with standard shielding. The two groups were similar at baseline.
    What it found
    No significant difference in door-to-balloon time, no meaningful delay in any individual step, and no association between the EggNest Complete room and door-to-balloon time in multivariable analysis. The study did not measure scatter, and was not powered for clinical outcomes.16
    Read the paper
  • 14

    Comparative effectiveness of the EggNest Complete shielding system to standard shielding in the cath lab

    Riley RF, Kamen J, Tao A, Gomez-Cardona D. Am Heart J Plus. 2025;54:100543

    • Up to 97%reduction against standard shielding for everyone in the room14

    EggNest Complete gave lower scatter than standard shielding at every position, height and angulation measured.14

    Method and full results
    What it measured
    Scatter at six staff positions, every 20 cm from 20 to 200 cm above the floor, in five C-arm angulations, around an anthropomorphic phantom. Three conditions: no shielding, standard cath lab shielding and EggNest Complete.
    What it found
    EggNest Complete gave lower scatter than standard shielding at every position, height and angulation measured (p < 0.01).14
    • 95.6%operator14
    • 91.2%assistant14
    Reduction against standard shielding, by position, average of five angulations14
    PositionReduction
    Echo or EP implanter96%
    Anesthesia or jugular access85%
    EP assistant97%
    Operator95%
    Assistant91%
    Nurse92%
    Read the paper
  • 1

    Comparative effectiveness of 2 next-generation scatter radiation shielding systems

    Riley RF, Kidd S, Power J, Stegman B, Dahle TG. JSCAI 2025;4(8):103786

    • 80%lower than Rampart IC at the head of the bed and nurse positions1

    Similar protection to the Rampart IC system at the operator and assistant positions, and significantly lower scatter at the head of the bed and the nurse position.1

    Method and full results
    What it measured
    Scatter at five staff positions, 20 to 200 cm above the floor, in five C-arm angulations, around an anthropomorphic phantom: no shielding, the Rampart IC system and EggNest Complete. The position beside the right chest was dropped because the Rampart IC system occupied it.
    What it found
    Both systems lowered scatter at the operator and assistant positions compared with no shielding. At the head of the bed and the nurse position, EggNest Complete gave significantly lower scatter (p < .01), which the Rampart IC system did not.1
    Average scatter by position, µSv/h, all heights and five angulations1
    PositionNoneRampart ICEggNest
    Echo or EP474911
    Anesthesia or jugular25626960
    Operator137195
    Assistant4421
    Nurse58599
    Average1148318
    Read the paper
Other publications, and papers on the problem8 documents

Other publications

  • 15

    Keeping everyone safe in the cath lab

    Riley RF. Cardiac Interventions Today. May/June 2025;19(3):17–20. Sponsored insert.

    What it describes
    One complex coronary case, a chronic total occlusion treated with atherectomy and intravascular lithotripsy, in a lab fitted with EggNest Complete. Every team member wore a 0.125 mm apron and a real-time dosimetry badge. Total air kerma for the case was 2,106 mGy.
    What it reports
    Scatter doses were negligible for every team member in the room. The dosimetry display shown in the article reads 0.0 mrem accumulated dose on all four badges.15
    • 0.0 mremon each of four staff badges, one case15
    Read the article
  • 5

    Is Egg ready to leave the nest and fly?

    Odanovic N, Gonzalez PE, Vora AN. JSCAI 2025;4(8):103863

    What it says
    An editorial on reference 1, in the same issue. It finds that both systems gave substantial protection, similar at the operator and assistant positions, with EggNest Complete reducing exposure more at the other positions. It calls the study timely and says the protection holds for staff as well as operators.5
    What it cautions
    Both systems were measured against no shielding, so the difference “may be somewhat overstated”. It is a phantom bench study with no real-world data, and with no agreed measurement method the design could favor EggNest.5
    Its estimate
    For a high-volume operator (400 diagnostic cases and 200 PCIs a year, about 250 hours of fluoroscopy equivalent) working with EggNest Complete and no other shielding, about 1.25 mSv a year: 2.5% of the NRC annual limit. 0.25 mSv for the assistant. A rough calculation from reference 1’s phantom figures, not a measurement.5
    • 1.25 mSva year for a high-volume operator, estimated5
    • 2.5%of the NRC annual dose limit5
    Read the editorial

Scatter Matters

Papers on the problem

  • 13

    Phantom-based evaluation of scatter radiation at clinically relevant positions in fluoroscopy-guided cardiac procedures

    Wilson RF, Steege P, Tao A, Gomez-Cardona D, Gainor JP, Riley RF, Kamen J. JSCAI 2025

    What it measured
    Unshielded scatter at six staff positions, 20 to 200 cm above the floor, in five C-arm angulations, around an anthropomorphic phantom, as a proposed standard method for testing shielding systems.
    What it found
    Scatter is highest near the head of the table and below it. Angled views, especially right anterior oblique and caudal, raised scatter sharply.13
    • 4.1×scatter at the three head-of-table positions against the other three13
    • 67%of scatter directed below the table, PA projection13
    • >96%of the primary beam absorbed or scattered into the room13
    Read the paper
  • 6

    Occupational health risks in cardiac catheterization laboratory workers

    Andreassi MG, Piccaluga E, Guagliumi G, et al. Circ Cardiovasc Interv. 2016;9(4):e003273

    • 3×higher cancer risk for interventional lab staff6
    • 6×higher cataract risk6
    • 7×higher orthopedic injury risk6
  • 4

    Cancer risk from professional exposure in staff working in cardiac catheterization laboratory

    Venneri L, et al. Am Heart J. 2009;157(1):118–124

    Approach
    Estimates cath lab staff cancer risk using the National Research Council's BEIR VII report.
  • 11

    Occupational hazards in cardiac electrophysiology

    Tamirisa K, et al. Heart Rhythm. 2025;23:e307–e318

    Approach
    A survey of Heart Rhythm Society members.
  • 12

    Radiation realities: radiation safety practices and awareness among interventional echocardiographers in the United States

    Wessly P, et al. Structural Heart. 2026;10(2):100785

  • 9

    Variability in state-level regulations regarding occupational radiation exposure

    Vora AN, Hermiller JB, Gupta R, et al. JSCAI 2025;4(6):103597, Figure 1

    Why it is here
    Whether staff may work without an apron depends on hospital, state and country rules.

Presented abstracts

Two of the fourteen abstracts presented since 2018 are listed here.

  • 7

    TCT-1061: Comparative effectiveness of a novel scatter radiation shielding system versus standard shielding

    Frizzell J, et al. J Am Coll Cardiol. 2025;86:B453

    • 0.16 mremoperator, per case7

    The assistant and the nurse each received 0.03 mrem per case, in real-world procedures, measured over the apron.7

    Method and full results
    What it measured
    Total-body dose per case by role in real-world procedures, jugular-access cases excluded, measured over the apron (ICRP 20).
    Study size
    Not yet sourced
    • 0.03 mremassistant7
    • 0.03 mremnurse7
    Read the abstract
  • 2

    TCT-248: A new device to markedly reduce cardiac cath lab radiation levels

    Wilson R, Gainor J, Valeti U, Montague J, Wilson B. J Am Coll Cardiol. 2018;72(13 Suppl):B103

    • 92%average reduction in total room scatter against standard shielding, five projections2

    EggNest lowered total room scatter against standard shielding in all five projections. A conference abstract, not a full paper.2

    Method and full results
    What it measured
    Scatter at six positions around an anthropomorphic phantom, from 20 to 200 cm above the floor, in five angiographic projections. Three conditions: no shielding, standard shielding (a 0.5 mm lead table skirt and hanging shield) and EggNest. The values for every position and height were summed into one total room figure.
    What it found
    Against standard shielding, EggNest lowered total room scatter in all five projections and significantly lowered scatter at each of the six positions in each projection. At single positions the reduction ran from 48% (assistant, LAO 40 cranial 30) to 98%. Standard shielding alone lowered total room scatter only slightly. A conference abstract, not a full paper.2
    Total room scatter, µSv/h, in the two projections the abstract gives in full2
    ViewNoneStandardEggNest
    PA10,0107,910640
    LAO 40 caudal 3038,91034,8702,040
    Read the abstract

Dr. Santiago Garcia: EggNest Data, CRT 2026

From the experts

Hear the data presented.

Talks and interviews on Egg Medical's YouTube channel.

More from the experts Egg Medical on YouTube
References
  1. Riley RF, Kidd S, Power J, Stegman B, Dahle TG. Comparative effectiveness of 2 next-generation scatter radiation shielding systems. J Soc Cardiovasc Angiogr Interv. 2025;4(8):103786. doi:10.1016/j.jscai.2025.103786.
  2. Wilson R, Gainor J, Valeti U, Montague J, Wilson B. TCT-248: A new device to markedly reduce cardiac cath lab radiation levels. J Am Coll Cardiol. 2018;72(13 Suppl):B103. doi:10.1016/j.jacc.2018.08.1376.
  3. Rizik DG, Sutton NR, Lansky AJ, Alasnag M, et al. SCAI/ASE/HRS/SIR/SVS expert consensus statement on enhanced radiation protection: time for mandatory and urgent action. J Soc Cardiovasc Angiogr Interv. 2026;5(8):105455. doi:10.1016/j.jscai.2026.105455.
  4. Venneri L, et al. Cancer risk from professional exposure in staff working in cardiac catheterization laboratory: insights from the National Research Council's BEIR VII report. Am Heart J. 2009;157(1):118–124. doi:10.1016/j.ahj.2008.08.009.
  5. Odanovic N, Gonzalez PE, Vora AN. Is Egg ready to leave the nest and fly? J Soc Cardiovasc Angiogr Interv. 2025;4:103863. doi:10.1016/j.jscai.2025.103863.
  6. Andreassi MG, Piccaluga E, Guagliumi G, Del Greco M, Gaita F, Picano E. Occupational health risks in cardiac catheterization laboratory workers. Circ Cardiovasc Interv. 2016;9(4):e003273. doi:10.1161/CIRCINTERVENTIONS.115.003273.
  7. Frizzell J, Gurevich S, Emani S, Guddeti R, Haddox K, Riley R, Henry T, Kereiakes D, Rudick S, Tribble S, Harper R, Bias A, Garcia S. TCT-1061: Comparative effectiveness of a novel scatter radiation shielding system versus standard shielding. J Am Coll Cardiol. 2025;86:B453. doi:10.1016/j.jacc.2025.09.1260.
  8. Salavitabar A, Vora AN, Altschul D, et al. ALARA+: Summit on radiation and orthopedic risks in fluoroscopic laboratories. J Soc Cardiovasc Angiogr Interv. 2026;5(4):104166. doi:10.1016/j.jscai.2025.104166.
  9. Vora AN, Hermiller JB, Gupta R, et al. Variability in state-level regulations regarding occupational radiation exposure (Figure 1). J Soc Cardiovasc Angiogr Interv. 2025;4(6):103597. doi:10.1016/j.jscai.2025.103597.
  10. Tamirisa K, et al. Occupational hazards in cardiac electrophysiology: insights from an HRS member survey. Heart Rhythm. 2025;23:e307–e318. doi:10.1016/j.hrthm.2025.10.001.
  11. Wessly P, et al. Radiation realities: radiation safety practices and awareness among interventional echocardiographers in the United States. Structural Heart. 2026;10(2):100785. doi:10.1016/j.shj.2025.100785.
  12. Wilson RF, Steege P, Tao A, Gomez-Cardona D, Gainor JP, Riley RF, Kamen J. Phantom-based evaluation of scatter radiation at clinically relevant positions in fluoroscopy-guided cardiac procedures. J Soc Cardiovasc Angiogr Interv. 2025. doi:10.1016/j.jscai.2025.103936.
  13. Riley RF, Kamen J, Tao A, Gomez-Cardona D. Comparative effectiveness of the EggNest Complete shielding system to standard shielding in the cath lab. Am Heart J Plus. 2025;54:100543. doi:10.1016/j.ahjo.2025.100543.
  14. Riley RF. Keeping everyone safe in the cath lab: "cracking" the code on radiation safety for all during complex PCI. Cardiac Interventions Today. 2025;19(3):17–20. Sponsored insert, Shockwave Medical. citoday.com.
  15. Hutchings J, Mai E, Blay SP, Ballinger C, Riley RF. Incorporating an enhanced radiation protection device into the treatment of ST elevation myocardial infarctions: a single center retrospective analysis. Am Heart J Plus. 2026;68:100816. doi:10.1016/j.ahjo.2026.100816.
  16. Guddeti RR, Schmidt CW, Riley RF, Kamen J, et al. Evaluating standard shielding versus novel enhanced radiation protection devices in the cardiac catheterization laboratory. J Am Heart Assoc. Published online 10 October 2026. doi:10.1161/JAHA.126.050577.

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