Radiation burden of patients undergoing endovascular abdominal aortic aneurysm repair
Received 4 July 2008; accepted 6 September 2008.
Introduction
Endovascular repair of abdominal aortic aneurysm (EVAR) requires the patient's extended exposure to x-rays, before, during, and after the intervention. The aim of this study was to determine the radiation exposure of patients undergoing EVAR and to assess the probability for the induction of both late and early radiation-related effects.
Methods
During the period of May 2006 to December 2007 EVAR was carried out in 62 patients using a mobile C-arm unit. The following dosimetric quantities were assessed: fluoroscopy time, cumulative dose in air, dose-area product, field area, and peak skin dose.
Results
The duration of fluoroscopy and the body mass index were found to be the main factors that influence the radiation burden in our hospital. The mean effective dose per procedure, 6.2 mSv, was between that from a planar coronary angiography and a coronary angioplasty. Taking into account the computed tomography (CT) procedure-related angiographies carried out during the first year, patients receive a total effective dose of about 62 mSv within the first year. In vivo dosimetry showed that the peak skin dose was linearly correlated with cumulative dose in air and did not exceed 1.0 Gy, ie, it was less than the threshold for any acute skin reaction.
Conclusion
Repair of abdominal aortic aneurysm results in substantial radiation burden. Radiation-related risks for carcinogenesis and skin injuries are factors that have to be taken into account in the selection of the strategy of each facility.
aDepartment of Medical Physics, Medical School, University of Ioannina, Ioannina, Greece
bDepartment of Vascular Surgery, Medical School, University of Ioannina, Ioannina, Greece
cDepartment of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
Correspondence: Prof John A. Kalef-Ezra, Medical Physics Laboratory, Medical School, University of Ioannina, 451.10 Ioannina, Greece
ABSTRACT