Operator-controlled imaging significantly reduces radiation exposure during EVAR

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Imaging

Background:

• Endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) reduces short-term risks.
• EVAR procedures can involve significant radiation exposure for patients and staff.
• Optimizing imaging techniques is crucial for enhancing EVAR safety.

Purpose of the Study:

• To evaluate the impact of transitioning from radiographer-controlled to operator-controlled imaging (OCI) on radiation exposure during EVAR.
• To assess changes in screening time and contrast dose following the implementation of OCI.

Main Methods:

• Retrospective analysis of 122 elective EVAR procedures for infra-renal AAA.
• Data collected included dose area product (DAP), screening time, contrast volume, and operative duration.
• Comparison of outcomes before and after the implementation of OCI.

Main Results:

• Median DAP was significantly lower after OCI implementation (4.9 mGy m² vs. 6.9 mGy m²; p = 0.005).
• Median screening times decreased from 20.0 min to 16.2 min (p = 0.027).
• No significant difference was observed in median contrast volumes (100 ml vs. 90 ml; p = 0.21).

Conclusions:

• Operator-controlled imaging significantly reduces radiation exposure during EVAR.
• OCI implementation leads to shorter screening times.
• OCI is effective in reducing high-dose radiation cases in EVAR procedures.