Radiation dose to the interventionalist is directly affected by the operating position

Area of Science:

• Medical Imaging
• Radiation Safety
• Vascular Surgery

Background:

• Endovascular aneurysm repair (EVAR) involves significant radiation exposure for medical staff.
• Optimizing operator positioning is essential for minimizing radiation doses during fluoroscopic procedures.

Purpose of the Study:

• To determine the optimal interventionalist positioning to reduce radiation exposure during EVAR.
• To quantify radiation absorption differences based on operator proximity to the image intensifier (II) and other personnel.

Main Methods:

• Prospective monitoring of radiation absorption in two vascular surgeons and one trainee during 10 routine EVAR procedures.
• Varied surgeon positions relative to the image intensifier (II) and trainee.
• Measured radiation doses to the body, eyes, and extremities.

Main Results:

• Surgeon A, positioned adjacent to the trainee and further from the II, absorbed significantly less radiation (body, eye, extremity) compared to Surgeon B.
• Surgeon A also had significantly lower radiation doses compared to the trainee.
• Radiation absorption varied considerably based on interventionalist position relative to the II and other operators.

Conclusions:

• Operator positioning relative to the image intensifier (II) and colleagues is a critical factor in radiation exposure during EVAR.
• Positioning adjacent to the trainee, though potentially hindering direct assistance, substantially minimizes radiation exposure for the interventionalist.
• These findings underscore the importance of strategic positioning for radiation safety in endovascular procedures.