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

We aimed to determine the optimal positioning of the interventionalist with regard to radiation exposure during endovascular aneurysm repairs (EVAR). The radiation absorption of two vascular surgeons and one trainee was prospectively monitored during a series of 10 routine EVARs. Position of the two vascular surgeons varied: surgeon A stood adjacent to the trainee and one person down from the image intensifier (II), whereas surgeon B stood directly across from the trainee at the same level as the II. Surgeon A absorbed significantly less mean body (0.004 mSv versus 0.036 mSv; P = 0.001), eye (0.036 versus 0.222 mSv; P < 0.001) and extremity (0.034 versus 0.212 mSv; P < 0.001) radiation doses compared with surgeon B and also had significantly lower doses of absorbed body (0.004 versus 0.04 mSv; P = 0.047), eye (0.036 versus 0.25 mSv; P = 0.043) and extremity (0.034 versus 0.248 mSv; P = 0.05) radiation relative to the trainee. In conclusion, there is considerable variation in radiation absorption due to the position of the interventionalist relative to the II and other operators. Although positioning of the operator next to the trainee may make it more difficult to assist and teach technical maneuvers, it greatly minimizes radiation exposure to the interventionalist.