Koos Geleijns PhD, Presenter: Nothing to Disclose

Olivier H.J. Koning MD, Abstract Co-Author: Nothing to Disclose

Hajo H. van Bockel MD, PhD, Abstract Co-Author: Nothing to Disclose

To assess cumulative patient dose and to calculate associated radiation risks for patients undergoing abdominal endovascular aortic aneurysm repair (EVAR).

A traditional protocol and a reduced dose scenario for medical imaging in EVAR planning, repair and surveillance was assumed and patient dose was assessed. The excess relative radiation risk was calculated using a model for age-, gender- and site-specific solid cancer mortality. Life tables were used to calculate risk related parameters for patients that underwent EVAR at 55, 65, 75 and 85 years of age. In addition to radiation risk, mortality rates that are typical for the EVAR population were taken into account, knowingly the probability of 30-day mortality and the mortality rate from AAA-related causes in general during follow-up.

Effective dose for EVAR planning was 18 (8) mSv; for EVAR repair 10 (10) mSv; and during the first, second and subsequent years of surveillance 87.5 (35) mSv/y, 35 (17.5) mSv/y and 17.5 (17.5) mSv/y. The number of radiation induced deaths per 1000 EVAR patients was 12 (10), 8 (6), 4 (3) and 1 (1) for patients treated at ages 55, 65, 75 and 85 years (respectively traditional protocol and between brackets reduced dose scenario). The corresponding number of abdominal aortic aneurysm (AAA) related deaths per 1000 EVAR patients was: 126, 91, 67 and 47, respectively (for both the traditional protocol and the reduced dose scenario). The average radiation induced reduction of life expectancy was 40 (30), 21 (15), 8 (5) and 2 (1) days for patients treated at ages 55, 65, 75 and 85 years; corresponding AAA related reduction of life expectancy was 739 (740), 387 (387), 197 (197) and 82 (82) days (respectively traditional protocol and between brackets reduced dose scenario).

Radiation exposure accumulates rapidly for patients undergoing surveillance after abdominal EVAR. However, associated radiation risks are modest, even for the traditional surveillance protocol that is associated with a relatively high patient dose.

Radiation risks in EVAR patient are modest and much smaller compared to AAA related risks.

Geleijns, K, Koning, O, van Bockel, H, Endovascular Abdominal Aortic Aneurysm Repair: Patient Dose and Radiation Risks.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8011053.html