Abstract
ObjectiveThe endovascular repair of aortic abdominal aneurysms exposes the patients and surgical team to ionizing radiation with risk of direct tissue damage and induction of gene mutation. This study aims to describe our standard of radiation exposure in endovascular aortic aneurysm repair and the factors that influence it.MethodsRetrospective analysis of a prospective database of patients with abdominal infra-renal aortic aneurysms submitted to endovascular repair. This study evaluated the radiation doses (dose area product (DAP)), fluoroscopy durations and their relationships to the patients, aneurysms, and stent-graft characteristics.ResultsThis study included 127 patients with a mean age of 73 years. The mean DAP was 4.8 mGy.m2, and the fluoroscopy time was 21.8 minutes. Aortic bilateral iliac aneurysms, higher body mass index, aneurysms with diameters larger than 60 mm, necks with diameters larger than 28 mm, common iliac arteries with diameters larger than 20 mm, and neck angulations superior to 50 degrees were associated with an increased radiation dose. The number of anatomic risk factors present was associated with increased radiation exposure and fluoroscopy time, regardless of the anatomical risk factors.ConclusionThe radiation exposure during endovascular aortic aneurysm repair is significant (mean DAP 4.8 mGy.m2) with potential hazards to the surgical team and the patients. The anatomical characteristics of the aneurysm, patient characteristics, and the procedure's technical difficulty were all related to increased radiation exposure during endovascular aortic aneurysm repair procedures. Approximately 40% of radiation exposure can be explained by body mass index, neck angulation, aneurysm diameter, neck diameter, and aneurysm type.
Highlights
The number and complexity of endovascular therapies are increasing in the current treatment of aortic aneurysms
Retrospective analysis of a prospective database of patients with abdominal infra-renal aortic aneurysms submitted to endovascular repair
The number of anatomic risk factors present was associated with increased radiation exposure and fluoroscopy time, regardless of the anatomical risk factors
Summary
The number and complexity of endovascular therapies are increasing in the current treatment of aortic aneurysms. As a result of this conduct change, vascular surgeons are frequently involved in procedures requiring high doses of ionizing radiation, which exposes the surgical team and the patients to potential hazards. This exposure is a necessary and accepted feature of modern vascular surgical practice, yet the training in radiation usage and protection is below ideal, among surgeons[1,2]. It is estimated that cardiology interventional procedures cause 83 cancer cases per 100,000 procedures[3]. The consequences of radiation usage in vascular interventions are less well studied
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