Radiation exposure of vascular surgery patients beyond endovascular procedures

Medical imaging evaluations provide valuable information and are often imperative in the care of our patients. Radiation exposure in patients who undergo medical imaging procedures is not routinely monitored and the associated risks are often underestimated.

Radiation exposure associated with computed tomography (CT) angiography and coronary intervention is reviewed.

Vascular surgeons are often involved in the decision-making process in roughly 30% of CT scans performed that are believed to be unnecessary. Society for Vascular Surgery (SVS) practice guidelines for patients with abdominal aortic aneurysms recommended eliminating a 6-month contrast surveillance CT if no endoleak was observed at 1 month after endovascular aneurysm repair (EVAR). Ultrasound and aortic duplex can help eliminate some of the CT scans.

Vascular surgeons must remain vigilant in monitoring radiation exposure for their patients who have potential for coronary and vascular imaging with radiation. Judicious use of alternative imaging modalities when possible and maintaining the dose as low as reasonably achievable (ALARA) is the responsibility of vascular surgeons.