Risk of radiation exposure during endovascular aortic repair

Area of Science:

• Medical Physics
• Cardiovascular Surgery
• Radiology

Background:

• Radiation exposure above 2 Gray (Gy) can cause skin burns.
• A lifetime cancer risk of approximately 5.5% exists for every Sievert (Sv) of radiation exposure.
• Assessing radiation burden in endovascular aortic repair is crucial for patient safety.

Purpose of the Study:

• To evaluate the radiation doses received by patients undergoing different types of endovascular aortic repair.
• To identify patient groups or procedures associated with higher radiation exposure.
• To inform strategies for reducing cumulative radiation dose in endovascular aortic surgery.

Main Methods:

• Dosimetric parameters including fluoroscopy time and dose area product (DAP) were prospectively recorded.
• Skin doses were measured using exposure films placed on 10 patients during surgery.
• Calculations were performed to determine equivalent skin doses (Gy) and whole-body effective doses (Sv).

Main Results:

• The branched/fenestrated endovascular aortic repair (BEVAR/FEVAR) group had a significantly higher median DAP compared to infra-renal (IEVAR) and thoracic endovascular aortic repair (TEVAR) groups.
• Equivalent skin doses ranged from 0.44 Gy to 13.7 Gy across the procedures.
• Whole-body effective doses varied, with BEVAR/FEVAR showing a median of 0.096 Sv, IEVAR 0.053 Sv, and TEVAR 0.058 Sv.

Conclusions:

• Radiation exposure in endovascular aortic surgery is typically low but can be substantial for some individuals.
• High radiation doses necessitate efforts to minimize intraoperative exposure.
• Developing non-radiation-based surveillance methods could help reduce long-term cancer risks.