Back to Search
Start Over
Endovascular aortic sealing with Nellix reduces intraoperative radiation dose when compared to endovascular aortic repair.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2018 Apr; Vol. 67 (4), pp. 1068-1073. Date of Electronic Publication: 2017 Oct 09. - Publication Year :
- 2018
-
Abstract
- Objective: To analyze radiation exposure during endovascular aortic sealing (EVAS) in comparison with standard endovascular aortic repair (EVAR) in clinical practice.<br />Methods: From December 2013 to October 2016 (35 months), 60 patients were analyzed for intraoperative radiation exposure during EVAR: 30 consecutive patients (mean age, 73.10 years; 28 male) received EVAS (Nellix Endologix); within the same time frame, 30 patients were treated with standard EVAR (mean age, 71.87 years; 30 male). An indirect dose analysis was performed for both groups of patients, including effective dose and cumulative air kerma. Furthermore, fluoroscopy time (FT), dose area product, and time of procedure were included in the study.<br />Results: The effective dose was significantly reduced in the EVAS group (3.72 mSv) compared with the group treated with standard EVAR (6.8 mSv; P ≤ .001). The cumulative air kerma was also lowered in EVAS (67.65 mGy vs 139 mGy in EVAR; P ≤ .001). FT for the entire group was 13 minutes and was shorter (P < .001) for EVAS (9 minutes) in comparison with EVAR (19 minutes). The dose area product for the entire cohort was 16.95 Gy.cm <superscript>2</superscript> and was lower during EVAS (12.4 Gy.cm <superscript>2</superscript> ) than during EVAR (22.6 Gy.cm <superscript>2</superscript> ; P < .001). The median operating time for the entire group was 123.5 minutes and was significantly shorter (P < .01) for EVAS (119 minutes vs EVAR at 132 minutes). The FT shows a significant correlation with the patient's weight (P = .022), body mass index (P = .004), and time of procedure (P = .005).<br />Conclusions: EVAS is associated with a relevant decrease in indirect measured radiation dose and time of procedure compared with standard EVAR. A relevant reduction in dose during EVAS is highly likely to result in lower exposure to radiation for physicians and staff. Such a result would be highly advantageous and calls for further analysis.<br /> (Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aortography adverse effects
Blood Vessel Prosthesis Implantation adverse effects
Body Mass Index
Body Weight
Endovascular Procedures adverse effects
Female
Humans
Male
Operative Time
Predictive Value of Tests
Prosthesis Design
Radiation Exposure adverse effects
Radiation Monitoring
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Angiography, Digital Subtraction adverse effects
Aorta diagnostic imaging
Aorta surgery
Aortography methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation instrumentation
Computed Tomography Angiography adverse effects
Endovascular Procedures instrumentation
Radiation Dosage
Radiation Exposure prevention & control
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 67
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29032904
- Full Text :
- https://doi.org/10.1016/j.jvs.2017.07.126