Back to Search
Start Over
Patient radiation exposure from embolo-sclerotherapy of peripheral vascular malformations.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2021 May; Vol. 73 (5), pp. 1794-1799. Date of Electronic Publication: 2020 Oct 16. - Publication Year :
- 2021
-
Abstract
- Objective: Embolo-sclerotherapy (EST) is the mainstay therapy for peripheral vascular malformations that involves the exposure of patients to ionizing radiation. We analyzed the radiation exposure to patients from EST of peripheral vascular malformations during a 5-year period in a single specialist center.<br />Methods: All patients who had undergone EST at a single specialist center for peripheral vascular malformations from January 1, 2013 to January 8, 2018 were identified from a prospectively collected database. Data collection included basic demographics, procedure date, anatomic site, type of vascular malformations, and procedural details. Radiation exposure, measured as the dose-area product (DAP) and fluoroscopy time, of all patients who had undergone EST during the study period were retrospectively reviewed. Statistical analysis was performed using the Mann-Whitney U and Kruskal-Wallis tests for comparison between subgroups. P < .05 was considered statistically significant.<br />Results: A total of 237 patients (median age, 30 years; range, 1-73 years) had undergone 419 EST sessions during the study period. Of the 237 patients, 61 (25.7%) had had arteriovenous malformations (AVMs) and had undergone 140 EST sessions (33.4%) and 176 (74.3%) had had venous and lymphatic malformations and had undergone 279 EST sessions (66.6%). Patients with AVMs had undergone a median of 2 procedures (range, 1-13) compared with a median of 1 (range, 1-6) for venous and lymphatic malformations within the study period. The median DAP for the single and cumulative EST for peripheral vascular malformations was 1.26 Gycm <superscript>2</superscript> (range, 0.00-698.36 Gycm <superscript>2</superscript> ) and 1.91 Gycm <superscript>2</superscript> (range, 0.00-1300.24 Gycm <superscript>2</superscript> ), respectively. The median fluoroscopy time for single and cumulative EST was 19 seconds (range, 1-3846 seconds) and 30 seconds (range, 1-5843 seconds), respectively. Significantly greater patient radiation exposure, in DAP and fluoroscopy time, was measured for single and cumulative EST for AVMs compared with venous and lymphatic malformations (P < .01 for both; Mann-Whitney U test). A significant difference in DAP but not fluoroscopy time was found when the anatomic areas of vascular malformations were compared.<br />Conclusions: Patient radiation exposure for EST for peripheral vascular malformations, measured in DAP and fluoroscopy time, appeared to be generally less than that reported for endovascular arterial and deep venous interventions. However, some patients with peripheral vascular malformations received relatively high radiation doses. Further studies to investigate the risk factors and long-term side effects of radiation exposure in these patients and strategies to reduce these are required.<br /> (Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Arteriovenous Malformations diagnostic imaging
Arteriovenous Malformations therapy
Child
Child, Preschool
Databases, Factual
Female
Humans
Infant
Lymphatic Abnormalities diagnostic imaging
Lymphatic Abnormalities therapy
Male
Middle Aged
Patient Safety
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Vascular Malformations diagnostic imaging
Veins abnormalities
Veins diagnostic imaging
Young Adult
Embolization, Therapeutic adverse effects
Radiation Dosage
Radiation Exposure adverse effects
Radiography, Interventional adverse effects
Sclerotherapy adverse effects
Vascular Malformations therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 73
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33075453
- Full Text :
- https://doi.org/10.1016/j.jvs.2020.08.152