Occupational exposure during endovascular aneurysm repair (EVAR) and aortoiliac percutaneous transluminal angioplasty (PTA) procedures.

Abstract

The purpose of this study was to determine the radiation exposure of primary interventionalist's different body parts during endovascular aneurysm repair (EVAR) procedures and aortoiliac percutaneous transluminal angioplasty (PTA) procedures and to evaluate the efficacy of a radioprotective drape. Occupational doses for 36 consecutive aortoiliac PTA procedures and 17 consecutive EVAR procedures were estimated using thermoluminescence dosimetry (TLD) chips (TLD-200, Hashaw, Solon, OH). Effective dose (ED) was calculated using the Niklason algorithm. For the evaluation of a 0.25mm Pb equivalent drape (Ecolab, Saint Paul, Minnesota, USA), experiments were performed using two physical anthropomorphic phantoms (Rando-Alderson Research Labs, CA, USA). Median ED for a typical EVAR and PTA procedure was 4.7 ± 1.4μSv and 4.4 ± 3.6μSv, respectively. The highest radiation doses were measured for the operator's hands in both procedures. Moreover, considerable doses were measured to the operator's head, eye lenses and thyroid. Due to the use of the drape, radiation exposure of primary operator's abdominal area, genitals, thyroid and eye lenses was reduced by an average of 59%, 60%, 65% and 59%, respectively. However, dose area product (DAP) and peak skin dose(PSD) were increased by 20% when part of the drape was placed into the X-ray field. During EVAR and PTA procedures, primary operator's organs are exposed to considerable radiation doses. Occupational radiation exposure can be reduced significantly with the proper use of a radioprotective drape.