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Radiation doses for endovascular aortic repairs performed on mobile and fixed C-arm fluoroscopes and procedure phase-specific radiation distribution.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2018 Dec; Vol. 68 (6), pp. 1889-1896. Date of Electronic Publication: 2018 Jun 28. - Publication Year :
- 2018
-
Abstract
- Objective: The objective of this study was to analyze radiation risk to patients during endovascular aneurysm repair (EVAR) using mobile C-arm (MA) or fixed C-arm (FA) fluoroscopes and to describe the dose distribution during the different phases of the procedure.<br />Methods: Patients treated with EVAR using a single stent graft system between November 2009 and June 2016 were included in this study. The patients were divided into one of two groups (MA or FA) according to the type of C-arm used in the procedure. Data regarding patients' demographics and the total amount of contrast agent (CA) used, dose-area product, and fluoroscopy time for the procedures were prospectively recorded. Based on the dose report from the FA system, five standard and two optional phases of the procedure were identified to determine the dose distribution.<br />Results: Overall, 160 patients were included (mean age, 73.30 ± 8.97 years; 146 men); of these, 107 were treated with an MA system and 53 were treated with an FA system. The mean amounts of CA used were 108.55 ± 42.28 mL in the MA group and 85.37 ± 38.79 mL in the FA group (P = .0014). The mean total dose-area product values were 49.93 ± 38.06 Gy·cm <superscript>2</superscript> in the MA group and 168.34 ± 146.92 Gy·cm <superscript>2</superscript> in the FA group (P < .0001). There was no significant difference in fluoroscopy time between the groups. Per-phase analysis demonstrated that identification of the proximal landing zone and main body deployment required the most radiation, accounting for 24% of the total radiation dose. Overall, 47.6% of the exposure was due to digital subtraction angiography.<br />Conclusions: Use of an FA system can significantly reduce the amount of CA needed but may also lead to higher radiation doses in EVAR procedures. Dose monitoring remains crucial for the safety of both patients and operators. A detailed analysis of dose distribution is possible with modern systems, which may improve the quality of monitoring in the future.<br /> (Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Angiography, Digital Subtraction adverse effects
Aortography adverse effects
Blood Vessel Prosthesis
Equipment Design
Female
Fluoroscopy
Humans
Male
Predictive Value of Tests
Radiation Monitoring
Radiography, Interventional adverse effects
Retrospective Studies
Risk Factors
Stents
Time Factors
Treatment Outcome
Angiography, Digital Subtraction instrumentation
Aorta diagnostic imaging
Aorta surgery
Aortography instrumentation
Blood Vessel Prosthesis Implantation adverse effects
Blood Vessel Prosthesis Implantation instrumentation
Endovascular Procedures adverse effects
Endovascular Procedures instrumentation
Radiation Dosage
Radiation Exposure adverse effects
Radiography, Interventional instrumentation
Tomography Scanners, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 68
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30473030
- Full Text :
- https://doi.org/10.1016/j.jvs.2018.05.020