Abstract No. 379 - Comparison of patient radiation doses from digital subtraction and fluoro save acquisitions of femoral access sites prior to use of vascular closure devices

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Purpose Prior to use of femoral closure devices, evaluation of the femoral artery access and the suitability of the vessel for use of a vascular closure device is routinely performed. Digital subtraction angiography (DSA) and digital flouroscopic loop (DFL) technology both provide a means to acquire and store angiographic images. We sought to evaluate the image quality and radiation dose associated with each of these modalities. Materials and Methods Using a phantom we simulated angiographic acquisitions of the femoral artery in the AP and 35 degree oblique projections and measured the dose during DSA and DFL acquisitions. We retrospectively selected 60 adult patients from the radiology database who had undergone elective outpatient cerebral angiography using the three different DFL acquisition protocols (15 fps, 7.5 fps and 4 fps). We selected 20 patients who had DSA documentation of the femoral access site and 60 who had DFL documentation of the femoral access site. We then reviewed the images for diagnostic quality to determine if a femoral closure device could be safely employed. We subsequently looked up the dose parameters recorded for the acquisitions and compared the dose for the acquisitions. Results For the phantom studies we found that the dose on the AP acquisitions was lower than the Oblique acquisitions. The DSA dose was higher than the DFL dose. The image quality was diagnostic for evaluation of the femoral artery with regards to access site suitability for use of the femoral closure device on all the clinical studies. The average dose to the patient was 57.9 mGy for DSA acquisitions versus 6.5 mGy, 2.8 mGy and 2.4 mGy for 15 fps, 7.5 fps and 4 fps respectively (p Conclusion Use of the Fluoro save feature on modern angiography equipment yields adequate images for the evaluation of femoral access sites for suitability of femoral closure devices and decreases both patient and operator radiation doses.