Radiation exposure dose, operation and X-ray time for endovascular treatment of intracranial aneurysms: comparison of different surgical strategies

Abstract

Objective To compare the differences of different endovascular treatment strategies for intracranial aneurysms in radiation dose, operation time, and fluoroscopy time. Methods From April 2011 to September 2016, patients with intracranial aneurysm who underwent endovascular treatment in the Department of Neurosurgery, Shangluo Central Hospital were enrolled retrospectively. According to different endovascular treatment strategies, they were divided into exclusive coil embolization (COIL) group, balloon-assisted coiling (BAC) group, stent-assisted coiling (SAC) group, and flow diverting technology (FDT) group. The demographic and aneurysm data were collected, and the related evaluation indicators were tested and compared. Results A total of 119 patients with intracranial aneurysm received endovascular treatment were enrolled, 41 in COLI group, 32 in BAC group, 30 in SAC group, and 16 in FDT group. There were no significant differences in gender, age, and maximum diameter of aneurysms among the 4 groups. There were significant differences in the shape and location of aneurysms (all P<0.05). The operation time, fluoroscopy time and radiation dose in the SAC group were the longest or largest, and the difference was statistically significant compared with the other 3 groups (all P<0.05). However, there were no significant differences among the other 3 groups. Three months of follow-up showed no adverse reactions of skin erythema or hair loss in all patients. Conclusion In various endovascular treatment techniques, SAC has the longest operation time and fluoroscopy time, and the radiation dose is the highest, so attention should be paid to radiation safety when selecting this method. Key words: Intracranial aneurysm; Embolization, therapeutic; Endovascular procedures; Radiation exposure; Treatment outcome; Time factor