Techniques to reduce radiation and contrast volume during EVAR.

Area of Science:

• Interventional Radiology
• Medical Imaging
• Radiation Oncology

Background:

• Significant variability exists in radiation dose and contrast media used during endovascular aortic repair (EVAR).
• Minimizing these exposures is a priority to reduce associated toxicities for patients and staff.

Purpose of the Study:

• To outline strategies for reducing radiation exposure and contrast volume during EVAR.
• To emphasize the importance of adopting advanced imaging techniques and radiation protection principles.

Main Methods:

• Adherence to "as low as reasonably achievable" (ALARA) principles for radiation.
• Utilizing advanced imaging like image fusion and table-side X-ray control.
• Exploring alternative contrast agents (CO2, gadolinium) and imaging modalities (CEUS, IVUS).

Main Results:

• Routine use of image fusion in EVAR significantly decreases radiation and contrast agent usage.
• Systematic collimation and avoidance of magnification reduce scatter radiation.
• Automated injectors and alternative agents maintain image quality while lowering iodinated contrast volume.

Conclusions:

• Implementing radiation protection principles and advanced imaging techniques is essential for safer EVAR procedures.
• Operator training in radiation safety is vital.
• Emerging technologies like CEUS and IVUS show promise as alternatives to X-ray and iodinated contrast.