Abstract
A 36-year-old female patient, 20 weeks pregnant, was diagnosed with a left internal carotid artery aneurysm. Fluoroscopically guided repair was justified. A four-vessel cerebral angiogram was performed, and a left paraclinoid aneurysm was demonstrated. The patient subsequently underwent endovascular stent-assisted berry aneurysm repair. As the patient was pregnant, the procedure was preceded by consideration of the required radiation protection. The foetal dose was estimated as negligible. Active management of foetal exposures may improve radiation protection during pregnancy.
Highlights
Endovascular treatment of a pregnant patient constitutes additional radiation risk to the foetus, owing to the increased radiobiological sensitivity of foetal cells.[1]
Magnetic resonance imaging (MRI) was performed, showing a left internal carotid artery (ICA) aneurysm and infarction, which was possibly related to emboli from the aneurysm
A four-vessel cerebral angiogram was performed on the patient, and a left paraclinoid aneurysm, which appeared to be superiorly projecting, was demonstrated (Figure 1)
Summary
Endovascular treatment of a pregnant patient constitutes additional radiation risk to the foetus, owing to the increased radiobiological sensitivity of foetal cells.[1]. A 36-year-old female patient, who was 20 weeks pregnant, was referred to the Universitas Academic Hospital in Bloemfontein, with a suspected left internal carotid artery (ICA) aneurysm. Kisielewicz et al formulated a relationship to estimate the patient entrance surface dose (ESD) from the DAP values.[2] This relationship, can only be used as a guideline because the parameters used in this case and that used by Kisielewicz et al differ to some extent Using this relationship, the patient ESD, after the four-vessel angiogram, was 100.82 mGy and for the endovascular stent-assisted aneurysm repair was 826.45 mGy, which was found to be 23.67% of the diagnostic reference level (DRL) used in our Department
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