Determinants of radiation exposure during EVAR

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Imaging

Background:

• Endovascular aneurysm repair (EVAR) is a standard treatment for aortic aneurysms.
• EVAR procedures involve patient exposure to ionizing radiation.
• Aneurysm neck morphology is a key factor in EVAR suitability and outcomes.

Purpose of the Study:

• To investigate the relationship between aortic aneurysm neck morphology and radiation exposure during EVAR.
• To determine if anatomical variations in the aneurysm neck influence radiation dose, screening time, and contrast volume.

Main Methods:

• Retrospective analysis of elective and emergency EVAR patients.
• Recording of anatomical parameters: proximal/distal neck diameter, neck length, neck angles, sac diameter.
• Measurement of radiological parameters: radiation dose, screening time, contrast volume.
• Statistical analysis using Pearson's correlation coefficient to assess relationships.

Main Results:

• Emergency EVAR patients had smaller mean neck diameters and larger mean sac diameters compared to elective patients.
• No significant differences in neck length or angles were observed between groups.
• Radiation dose showed no definite correlation with the seven anatomical parameters studied.
• Screening time and contrast volume were lower in emergency cases, with a non-significant trend towards higher radiation dose.

Conclusions:

• Aneurysm neck morphology does not appear to be a significant determinant of radiation exposure in EVAR.
• Observed differences in radiation exposure in emergency EVAR are more likely attributable to variations in surgical technique.