An Optimized Ultra-Low-Dose Imaging Protocol for Endovascular Aortic Repair Significantly Reduces Radiation and...

Area of Science:

• Vascular Surgery
• Medical Imaging
• Radiation Oncology

Background:

• Endovascular aortic repair (EVAR) involves significant radiation and contrast exposure.
• Optimizing imaging protocols is crucial for patient safety and reducing procedural risks.

Purpose of the Study:

• To assess the impact of a systematic, multi-component ultra-low-dose imaging protocol on radiation and contrast exposure during EVAR.
• To evaluate the protocol's effectiveness across various anatomical complexities.

Main Methods:

• Retrospective cohort study of 331 EVAR procedures.
• Comparison between an integrated ultra-low-dose protocol (Group A, n=228) and a standard low-dose protocol (Group B, n=103).
• Ultra-low-dose protocol included 2D/3D fusion, low-frame-rate fluoroscopy, restricted DSA, collimation, and CO2 angiography.

Main Results:

• Group A showed a 71% reduction in total dose-area product (DAP) compared to Group B (57.9 vs. 199.3 Gy·cm2).
• Contrast volume decreased by 20% (101 vs. 126 mL) without increasing fluoroscopy time.
• Technical success rates were comparable between groups (86% vs. 87%).

Conclusions:

• A protocolized, system-level ultra-low-dose imaging workflow significantly reduces radiation and contrast exposure during EVAR.
• This approach is effective across diverse anatomical complexities and does not compromise technical success.
• The integrated strategy enhances safety for both patients and procedural staff.