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Occupational Radiation Exposure During Endovascular Aortic Repair

  • Clinical Investigation
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Abstract

Purpose

The aim of the study was to evaluate the radiation exposure to operating room personnel and to assess determinants for high personal doses during endovascular aortic repair.

Materials and Methods

Occupational radiation exposure was prospectively evaluated during 22 infra-renal aortic repair procedures (EVAR), 11 thoracic aortic repair procedures (TEVAR), and 11 fenestrated or branched aortic repair procedures (FEVAR). Real-time over-lead dosimeters attached to the left breast pocket measured personal doses for the first operators (FO) and second operators (SO), radiology technicians (RT), scrub nurses (SN), anesthesiologists (AN), and non-sterile nurses (NSN). Besides protective apron and thyroid collar, no additional radiation shielding was used. Procedural dose area product (DAP), iodinated contrast volume, fluoroscopy time, patient’s body weight, and C-arm angulation were documented.

Results

Average procedural FO dose was significantly higher during FEVAR (0.34 ± 0.28 mSv) compared to EVAR (0.11 ± 0.21 mSv) and TEVAR (0.06 ± 0.05 mSv; p = 0.003). Average personnel doses were 0.17 ± 0.21 mSv (FO), 0.042 ± 0.045 mSv (SO), 0.019 ± 0.042 mSv (RT), 0.017 ± 0.031 mSv (SN), 0.006 ± 0.007 mSv (AN), and 0.004 ± 0.009 mSv (NSN). SO and AN doses were strongly correlated with FO dose (p = 0.003 and p < 0.001). There was a significant correlation between FO dose and procedural DAP (R = 0.69, p < 0.001), iodinated contrast volume (R = 0.67, p < 0.001) and left-anterior C-arm projections >60° (p = 0.02), and a weak correlation with fluoroscopy time (R = 0.40, p = 0.049).

Conclusion

Average FO dose was a factor four higher than SO dose. Predictors for high personal doses are procedural DAP, iodinated contrast volume, and left-anterior C-arm projections greater than 60°.

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Conflict of interest

AM Sailer, GWH Schurink, ME Bol, WH van Zwam, and CRLPN Jeukens stated that they have no conflict of interest to disclose; MW de Haan and JE Wildberger have received an institutional research grant from Philips Healthcare.

Statement of Informed Consent

This study was approved by the local ethical committee. Informed consent was obtained from all individual participants included in the study; written informed consent was waived.

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Authors and Affiliations

  1. Department of Radiology, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands

    Anna M. Sailer, Martine E. Bol, Michiel W. de Haan, Willem H. van Zwam, Joachim E. Wildberger & Cécile R. L. P. N. Jeukens

  2. Department of Surgery, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands

    Geert Willem H. Schurink

Authors
  1. Anna M. Sailer
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  2. Geert Willem H. Schurink
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  3. Martine E. Bol
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  4. Michiel W. de Haan
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  5. Willem H. van Zwam
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  6. Joachim E. Wildberger
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  7. Cécile R. L. P. N. Jeukens
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Correspondence to Anna M. Sailer.

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Sailer, A.M., Schurink, G.W.H., Bol, M.E. et al. Occupational Radiation Exposure During Endovascular Aortic Repair. Cardiovasc Intervent Radiol 38, 827–832 (2015). https://doi.org/10.1007/s00270-014-1025-8

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  • DOI: https://doi.org/10.1007/s00270-014-1025-8

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