Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 11/2012

01-11-2012 | Vascular-Interventional

The impact of radiological equipment on patient radiation exposure during endovascular aortic aneurysm repair

Authors: Rita Fossaceca, Marco Brambilla, Giuseppe Guzzardi, Paolo Cerini, Alessandra Renghi, Serena Valzano, Piero Brustia, Alessandro Carriero

Published in: European Radiology | Issue 11/2012

Login to get access

Abstract

Objectives

To compare the patient radiation dose during endovascular aortic aneurysm repair (EVAR) using different types of radiological systems: a mobile fluoroscopic C-arm, mobile angiographic and fixed angiographic equipment.

Methods

Dose–area products (DAP) were obtained from a retrospective study of 147 consecutive patients, subjected to 153 EVAR procedures during a 3.5-year period. On the basis of these data, entrance surface dose (ESD) and effective dose (ED) were calculated. EVARs were performed using a fluoroscopic C-arm, mobile or fixed angiographic equipment in 79, 26 and 48 procedures, respectively.

Results

Fluoroscopy times were essentially equivalent for all the systems, ranging from 15 to 19 min. The clinical outcomes were not significantly different among the systems. Statistically significant differences among radiological equipment grouping were found for DAP (mobile C-arm: 32 ± 20 Gy cm2; mobile angiography: 362 ± 164 Gy cm2; fixed angiography: 464 ± 274 Gy cm2; P < 10−6), for ESD (mobile C-arm: 0.18 ± 0.11 Gy; mobile angiography: 2.0 ± 0.8 Gy; fixed angiography: 2.5 ± 1.5 Gy; P < 10−6) and ED (mobile C-arm: 6.2 ± 4.5 mSv; mobile angiography: 64 ± 26 mSv; fixed angiography: 129 ± 76 mSv; P < 10−6).

Conclusions

Radiation dose in EVAR is substantially less with a modern portable C-arm than with a fixed or mobile dedicated angiographic system.

Key Points

• Fluoroscopy during endovascular aortic aneurysm repair can impart a substantial radiation dose.
• Radiation doses during EVAR are higher when using mobile/fixed angiographic systems.
• Mobile C-arm fluoroscopy imparts a lower dose with an equivalent clinical outcome.
• Procedures need to be dose-optimised when using mobile/fixed angiographic systems.
Literature
1.
EVAR trial participants (2005) Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised trial. Lancet 365:2179–2186CrossRef
2.
Prinssen M, Verhoeven EL, Buth J et al (2004) Dutch Randomised Endovascular Aneurysm Management (DREAM) trial group. A randomised trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 351:1607–1618PubMedCrossRef
3.
Jones C, Badger SA, Boyd CS, Soong CV (2010) The impact of radiation dose exposure during endovascular aneurysm repair on patient safety. J Vasc Surg 52:298–302PubMedCrossRef
4.
Geijer H, Larzon T, Popek R, Beckman KW (2005) Radiation exposure in stent-grafting of abdominal aortic aneurysms. Br J Radiol 78:906–912PubMedCrossRef
5.
Kpodonou J (2010) Hybrid cardiovascular suite: the operating room of the future. J Card Surg 25:704–709CrossRef
6.
Jones DG, Wall BF (1985) Organ doses from medical X-ray examinations calculated using Monte Carlo techniques. National Radiological Protection Board, Chilton
7.
Weerakkody RA, Walsh SR, Cousins C, Goldstone KE, Tang TY, Gaunt ME (2008) Radiation exposure during endovascular aneurysm repair. Br J Surg 95:699–702PubMedCrossRef
8.
9.
Trianni A, Bernardi G, Padovani R (2005) Are new technologies always reducing patient doses in cardiac procedures? Radiat Prot Dosimetry 117:97–101PubMedCrossRef
10.
Newton WB 3rd, Shukla M, Andrews JS et al (2011) Outcomes of acute intraoperative surgical conversion during endovascular aortic aneurysm repair. J Vasc Surg 54:1244–1250PubMedCrossRef
11.
Lipsitz EC, Veith FJ, Ohki T et al (2000) Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons? J Vasc Surg 32:704–710PubMedCrossRef
12.
Ho P, Cheng SW, Wu PM et al (2007) Ionizing radiation absorption of vascular surgeons during endovascular procedures. J Vasc Surg 46:455–459PubMedCrossRef
13.
Padovani R, Vano E, Trianni A et al (2008) Reference levels at European level for cardiac interventional procedures. Radiat Prot Dosimetry 129:104–107PubMedCrossRef
14.
ICRP (2000) Avoidance of radiation injuries from medical interventional procedures: ICRP Publication 85. Pergamon, Oxford
15.
Weiss DJ, Pipinos II, Longo GM, Lyinch TG, Rutar FJ, Johanning JM (2008) Direct and indirect measurement of patient radiation exposure during endovascular aortic aneurysm repair. Ann Vas Surg 22:723–729CrossRef
Metadata
Title
The impact of radiological equipment on patient radiation exposure during endovascular aortic aneurysm repair
Authors
Rita Fossaceca
Marco Brambilla
Giuseppe Guzzardi
Paolo Cerini
Alessandra Renghi
Serena Valzano
Piero Brustia
Alessandro Carriero
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 11/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2492-4

Other articles of this Issue 11/2012

European Radiology 11/2012 Go to the issue

Magnetic Resonance

Quantitative MR imaging and spectroscopy of brain tumours: a step forward?

Oncology

Assessment of pulmonary melanoma metastases with 18F-FDG PET/CT: which PET-negative patients require additional tests for definitive staging?

Head and Neck

Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy

Hepatobiliary-Pancreas

Differential diagnosis of sclerosing cholangitis with autoimmune pancreatitis and periductal infiltrating cancer in the common bile duct at dynamic CT, endoscopic retrograde cholangiography and MR cholangiography

Computer Applications

Integrated diagnostics: proceedings from the 9th biennial symposium of the International Society for Strategic Studies in Radiology

Molecular Imaging

Controllable labelling of stem cells with a novel superparamagnetic iron oxide–loaded cationic nanovesicle for MR imaging