Introduction - Fluoroscopically guided hybrid procedures have rapidly increased among vascular surgeons. During these interventions, the personnel are at risk of stochastic or deterministic effect of ionizing radiation. Minimizing the absorbed radiation dose is essential to reduce its harmful effects for the patients and personnel. The aim of our study was to quantify the effects of different imaging settings on the staff dose and patient skin dose with the active electronic dosimeters (AED). Methods - Measurements to determine radiation dose in different imaging and geometry settings were performed in a hybrid operation room (OR) equipped with a robotic C-arm interventional angiography system (Artis Zeego, Siemens Healthcare) with an anthropomorphic adult female phantom (ATOM 702-D, CIRS). Scattered radiation doses were measured with nine calibrated Philips DoseAware AEDs and a Raysafe Xi survey detector (Unfors Raysafe) that were placed at different locations in the OR mimicking the positions of surgeons and nurses during the procedure (Figure 1). Furthermore, a Raysafe R/F detector was placed under the phantom in the primary beam to measure the entrance surface air kerma. The evaluated imaging set-ups contained low-dose, medium-dose, and high-dose fluoroscopy for abdomen, low-dose DSA for abdomen, fluorofade, roadmap, and dyna-CT. The effect of magnification was evaluated with five magnification levels, tube angulation with ±30° settings, and field size, and source-to-skin distance with a few set-ups. We also determined the effects of RADPAD radiation protection shields (Worldwide Innovations and Technologies) on staff doses. Radiation was on for 20 seconds in all the imaging set-ups, except for Dyna-CT. The results are expressed as relative doses (RD) compared to the cumulative dose (1.05 μSv) measured with the AED B (“operating surgeon”) in the reference imaging setting with abdomen low-dose fluoroscopy program (4 pps) and C-arm in posterior-anterior position without magnification. Results - The use of fluorofade did not increase the cumulative dose (RD=1.1) whereas the roadmap increased it threefold (RD=3.1). The RD was 4.5 with normal-fluoro 7.5 pps instead of 4 pps and 7.0 when high-dose-fluoro was used 7.5 pps. The RDs for the magnifications 2,3,4 and 5 were 0.9, 1.0, 2.0, and 2.3 respectively. Decreasing the field-of-view to 25% of the reference field-of-view halved the radiation dose (RD=0.52). The RDs for the LAO 30° and RAO 30° were 1.6 and 2.1, respectively. The RADPAD shield decreased the cumulative dose to fifth (RD=0.23). DSA increased the cumulative dose 33-fold but the RADPAD shield decreased the DSA RD to 6.6. The RD for Dyna CT was 79. The patient skin dose in the reference setting was 229 μGy whereas 58-fold with the DSA. The doses in the AED D (“assisting nurse) were unmeasurable due to low dose in most of the set-ups. The AED F gained 4-fold doses compared to the AED E as the protection shields were on the right side of the table. Conclusion - Radiation exposure to personnel, as well as to the patients, can significantly be reduced in the hybrid OR procedures with optimization. For this purpose, the AEDs offer excellent tools.