Radiation exposure during endovascular aneurysm repair

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Radiation Oncology

Background:

• Endovascular stent-grafting is a common treatment for abdominal aortic aneurysms (AAA).
• This procedure requires prolonged fluoroscopic guidance, leading to significant radiation exposure.
• Assessing radiation doses during EVAR and surveillance is crucial for patient safety.

Purpose of the Study:

• To quantify the average radiation exposure during endovascular aneurysm repair (EVAR).
• To determine radiation doses during the first year of postoperative surveillance after EVAR.
• To evaluate the risk of radiation-induced skin damage and long-term cancer risk.

Main Methods:

• Prospective data collection of radiation dose area product (DAP) in 96 EVAR patients.
• Calculation of Entrance Skin Dose (ESD) to assess potential skin damage.
• Estimation of effective dose to evaluate long-term cancer risk.

Main Results:

• Median ESD during EVAR was 0.85 Gy, with 29% of procedures exceeding the 2 Gy threshold for skin damage.
• The effective radiation dose in the first year post-EVAR was 79 mSv.
• Radiation doses are higher than previously estimated, indicating a need for dose optimization.

Conclusions:

• EVAR procedures deliver substantial radiation doses.
• There is a notable risk of radiation-induced skin complications.
• Long-term cancer risks associated with EVAR radiation exposure warrant further investigation.