Jean-Christophe Gentric, Presenter: Nothing to Disclose

Brivael Trelhu, Abstract Co-Author: Nothing to Disclose

Pierre Jannin, Abstract Co-Author: Nothing to Disclose

Jean-Christophe Ferré MD, Abstract Co-Author: Nothing to Disclose

Jean Yves Gauvrit, Abstract Co-Author: Nothing to Disclose

Quantify effects of “Low Dose” (LD) protocol on the Neuro-Interventional procedure itself is difficult and subjective. The development and the use of workflow analysis allow objective evaluation of the impact of radiation exposure protocol on the operator’s activities duration.

Twenty two embolizations of cerebral aneurysms have been analyzed using a workflow analysis to study impact of a low dose protocol (reducing exposure of 20% per image) on operator’ activities duration. After selecting an adapted terminology, the procedure was divided into 6 phases made of a sequence of activities. The phases using X-rays were analyzed and separated into two phases of navigation and one phase of treatment. A trained observer used a Workflow editor to record the phases and single activities of the procedures. Each activity was live-recorded thanks to a tablet PC. We used the time of each phase and of each activity (mean time and total time) as a metrics to compare both protocols. The Wilcoxon test was used for statistical analysis.

1199 activities under LD protocol have been compared to 618 activities under Normal Dose protocol. For the navigation and treatment phases no statistical difference has been showed between both radiation exposure protocols. Especially for the following metrics: duration of the phases, total and mean time of activities of interest as fluoroscopy use to navigate or to place coils. While a strong link between the patient’s age and most of the metrics we used during the navigation phase.

Workflow analysis allows evaluating the impact of the radiation exposure during Neuro-interventional procedures. A such approach permits physicians to make their understanding of operator’s requirements explicit.

Modeling and analyzing procedures is an emerging approach to improve their safety and quality. The deconstruct process can be analyzed, changing purely subjective impressions into explicit data.

Gentric, J, Trelhu, B, Jannin, P, Ferré, J, Gauvrit, J, Workflow Analysis of the Impact of "Low-Dose" Radiation Exposure Protocol during Aneurysm Endovascular Treatment.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11010998.html