Anna Margaretha Sailer MD, MBA, Presenter: Nothing to Disclose

Geert Willem H. Schurink MD, PhD, Abstract Co-Author: Nothing to Disclose

Martine Bol, Abstract Co-Author: Nothing to Disclose

Michiel W. De Haan MD, PhD, Abstract Co-Author: Nothing to Disclose

Wim Van Zwam MD, Abstract Co-Author: Nothing to Disclose

Joachim Ernst Wildberger MD, PhD, Abstract Co-Author: Nothing to Disclose

Cecile R. L. Jeukens PhD, Abstract Co-Author: Nothing to Disclose

Aim of this study was to evaluate the radiation exposure to operating room personnel and its determinants during endovascular aortic repair procedures.

Occupational radiation exposure was prospectively evaluated during forty-four endovascular aortic repair procedures. Procedures were performed between 07/2013 and 01/2014 on our hybrid operating room (Allura Xper with ClarityIQ, Philips Medical Systems, Best, The Netherlands). Twenty-two infrarenal aortic procedures (EVAR), eleven thoracic aortic procedures (TEVAR) and eleven fenestrated or branched aortic procedures (FEVAR) were included. Real-time over-lead dosimeters attached to the left breast pocket (DoseAware, Philips) were used to measure personal doses for operators (first (FS) and second (SS) surgeon), radiology technicians (RT), scrub nurses (SN), and anesthesiologists (AN). Besides protective apron and thyroid collar, no radiation shielding was used. Procedural dose area product (DAP), iodinated contrast volume, fluoroscopy time, patients’ weight and angulation of the C-arm were documented. Results were analyzed using regression coefficient and Kruskal-Wallis test.

Average procedural over-lead dose and standard deviation was 0.17 ±0.21 mSv for the FS, 0.042 ±0.045 mSv for the SS, 0.019 ±0.042 mSv for the RT, 0.017 ±0.031 mSv for the SN and 0.006 ±0.007 mSv for the AN. FS doses were significantly higher during FEVAR compared to EVAR and TEVAR (mean FS dose during FEVAR: 0.34 ±0.28 mSv, EVAR: 0.11 ±0.21 mSv, TEVAR: 0.06 ±0.05 mSv; p= 0.003). There was a significant correlation between the dose of the FS and procedural DAP (R= 0.686, p< 0.001) and iodinated contrast volume (R= 0.672, p< 0.001) and a weak correlation with fluoroscopy time (R= 0.396, p= 0.049). Usage of left anterior C-arm projections >60 degrees was associated with significantly higher FS doses (p= 0.02). For EVAR procedures, a significant correlation between FS dose and patient’s weight was found (R= 0.561, p= 0.024). SS dose and AN dose were significantly correlated with the FS dose (R= 0.668, p= 0.003 and R= 0.838, p< 0.001).

Strong predictors for high personal doses are procedural DAP, iodinated contrast volume, patient weight and left lateral C-arm angulation >60 degrees.

The first surgeon received an average procedural dose of 0.17 mSv, which was on average a factor four higher than the second surgeon who received the second highest average dose.

Sailer, A, Schurink, G, Bol, M, De Haan, M, Van Zwam, W, Wildberger, J, Jeukens, C, Occupational Radiation Exposure during Endovascular Aortic Repair.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004564.html