The impact of radiation dose exposure during endovascular aneurysm repair on patient safety

Objective

Endovascular aneurysm repair (EVAR) exposes patients to radiation during the procedure and in subsequent follow-up. The study goal was to calculate the radiation dose in our unit and compare it against other published data and national guidelines.

Methods

All EVAR procedures were identified from a prospectively maintained database. Radiation dose, screening time, and volume of intravenous contrast during the procedure were reviewed. Radiation exposure from subsequent computed tomography (CT) imaging was included in the overall exposure. Results are expressed as mean ± standard deviation.

Results

From October 1998 to October 2008, 320 elective patients underwent EVAR. Mean screening time was 29.4 ± 23.3 minutes, and the radiation dose was 11.7 ± 7.1 mSv. The EVAR was an emergency in 64 patients. The mean screening time was 22.9 ± 18.2 minutes, and the radiation dose was 13.4 ± 8.6 mSv. During the first postoperative year, follow-up CT scans exposed the patients to 24.0 mSv, with 8.0 mSv in subsequent years. Abdominal radiographs added an additional 1.8 mSv each year.

Conclusion

EVAR and the follow-up investigations involve substantial amounts of radiation, with well-recognized carcinogenic risks. Because patient safety is paramount, radiation exposure should be minimized. This may be possible by standardizing radiation exposure throughout the United Kingdom by implementing national guidelines and considering other imaging modalities for follow-up.