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Introduction: The aim of this study is to quantify the association of temporary epilation following interventional neuroradiology (INR) procedures and compare the peak skin dose (D skin,max ) threshold to published values., Methods: Gold Coast University Hospital (GCUH) is a major centre for INR with over 500 primarily interventional procedures performed every year. D skin,max is calculated when the reference air kerma (K a,r ) exceeds 3 Gy. If the D skin,max exceeds 3 Gy, the patient is followed up for any skin effects. An audit was undertaken of these results over a 2-year period., Results: From January 2020 to December 2021, 140 patients who underwent INR procedures had a K a,r  > 3 Gy, 66 resulted in a calculated D skin,max  >3 Gy, and 45 were successfully followed up. Twenty patients (44%) reported no skin effects and 25 (56%) reported skin effects, which were almost exclusively epilation. The mean (range) D skin,max for patients with no reported skin effects and those with observed skin effects was 4.6 Gy (3.0-11.1 Gy) and 4.2 Gy (3.0-7.0 Gy), respectively., Conclusion: These results demonstrate that temporary epilation was observed in 56% of patients, in a cohort of 45 patients who underwent an INR procedure with calculated D skin,max  >3 Gy and successful follow-up. The results support evidence in the literature that suggests the approximate threshold for temporary epilation reported by the International Commission on Radiological Protection (ICRP) may be too high for incidence of this effect, specifically on the scalp, when D skin,max is calculated from K a,r (using commonly used corrections and assumptions in the calculation)., (© 2024 Royal Australian and New Zealand College of Radiologists.)

Introduction: This research evaluates the budget impact of treating acute ischaemic stroke (AIS) using a combination of mechanical thrombectomy (MT) with stent retrievers (SR) and intravenous tissue-plasminogen activator (IV-tPA) in Australia., Methods: This study examined the economic impact over five years for a patient cohort based on the number of patients treated with MT+ IV-tPA in Australia 2021, versus treatment with IV-tPA alone. A budget impact (BI) model was developed to project direct medical costs (economic impact) of IV-tPA+ MT with SR vs. Intravenous tissue-plasminogen activator alone over a five-year period (2021-2025 inclusive) from a healthcare perspective. The model is composed of a short-run decision tree model based on a 3-month post-treatment modified Rankin Scale (mRS) from the EXTEND-IA study and a published long-run Markov state transition model. Acute, mid-term and long-term care costs were projected based on anticipated mRS scores from the EXTEND-IA trial. Estimated yearly and cumulative budget impact were reported to indicate the economic impact of the two treatment strategies for AIS in the Australian healthcare system., Results: MT+IV-tPA had a greater budgetary impact than IV-tPA alone, with annual savings starting at Year 1 and continuing through to Year 5. Cost savings of 21% or approximately $36 million can be achieved over five years for the patient cohort treated in Australia in 2021. Each MT procedure performed delivers approximately $3280 in annual health system savings per patient., Conclusion: Treatment of AIS with a combination of MT+IV-tPA generates significant savings in the Australian healthcare system compared with IV-tPA alone., (© 2024 Stryker Neurovascular. Journal of Medical Imaging and Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Radiologists.)