Occupational radiation exposure during endovascular aortic procedures.
A P Patel1, D Gallacher, R Dourado
1Vascular Unit, Guy's & St Thomas' NHS Foundation Trust and King's College London, Cardiovascular Clinical Academic Group, King's Health Partners, United Kingdom.
Summary
Radiation exposure for operating teams during endovascular aortic repairs is higher for thoracic procedures. Digital subtraction angiography runs and C-arm obliquity predict operator dose, emphasizing the need for radiation safety measures.
Area of Science:
- Medical Imaging
- Interventional Radiology
- Radiation Safety
Background:
- Endovascular aortic repairs are increasingly common.
- Radiation exposure is an occupational hazard for healthcare professionals in interventional radiology.
- Minimizing radiation dose is crucial for the safety of the operating team.
Purpose of the Study:
- To quantify radiation exposure for the operating team during endovascular aortic procedures.
- To identify factors contributing to high radiation doses.
- To inform strategies for radiation dose reduction.
Main Methods:
- Prospective study using electronic dosimeters placed over and under lead garments.
- Radiation exposure recorded during endovascular aortic repairs.
- Univariate and multivariate regression analyses to identify predictors of exposure.
Main Results:
- Thoracic endovascular aortic repairs resulted in significantly higher operator radiation exposure (421.0 µSv) compared to infra-renal repairs (52.5 µSv).
- Under-lead exposure for the operator and assistant was low, generally within effective dose limits.
- Procedure type, digital subtraction angiography (DSA) time, and C-arm angulation (left anterior oblique) predicted operator dose.
Conclusions:
- Thoracic procedures, DSA utilization, and C-arm angulation are key predictors of radiation exposure.
- Understanding scatter radiation is essential for developing effective radiation protection strategies.
- Mandatory implementation of measures to minimize radiation exposure is recommended.
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