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Neurointerventionalist and Patient Radiation Doses in Endovascular Treatment of Acute Ischemic Stroke

  • Clinical Investigation
  • Radiation Protection
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the patient and the neurointerventionalist radiation dose levels during endovascular treatment of acute ischemic stroke, and to analyze factors affecting doses.

Materials and Methods

From October 2017 to January 2019, we prospectively collected patient radiation data and neurointerventionalist data from real-time dosimetry from all consecutive thrombectomies. Multivariate analysis was performed to analyze patient total dose area product (DAP) and neurointerventionalist dose variability in terms of clinical characteristics and the technical parameters of thrombectomies. Local dose reference levels (RL) were derived as the 75th percentile of the patient dose distributions.

Results

A total of 179 patients were treated during the study period and included in this study. Local dose RL for thrombectomy was derived for total DAP to 34 Gy cm2, cumulative air kerma of 242 mGy and fluoroscopy time of 12 min. The mean neurointerventionalist dose for thrombectomy was 7.7 ± 7.4 µSv. Height (P = 0.018), weight (P = 0.004), body mass index (P = 0.015), puncture to recanalisation (P < 0.001), fluoro time (P < 0.001), number of passes (P < 0.001), thrombolysis in cerebral infarction 2b/3 recanalisation (P = 0.034) and aspiration thrombectomy (P < 0.001) were independent factors affecting patient total DAP, whereas baseline National Institutes of Health Stroke Scale (P = 0.043), puncture to recanalisation (P = 0.003), fluoroscopy time (P = 0.009) and number of passes (P = 0.009) were factors affecting the neurointerventionalist dose.

Conclusion

New reference patient doses lower than those in previously published studies were defined. However, the operator’s doses were higher than those in the only available study reporting on operator’s dose during cerebral interventions.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. University Hospital Trnava, A. Zarnova 11, 917 75, Trnava, Slovakia

    Andrej Klepanec, Jan Harsany, Matus Hoferica, Georgi Krastev, Jozef Haring & Miroslav Mako

  2. University of Ss. Cyril and Methodius in Trnava, Namestie J. Herdu 2, 917 01, Trnava, Slovakia

    Andrej Klepanec, Dusan Salat & Lenka Janosikova

  3. Faculty of Medicine, Comenius University in Bratislava, Špitálska 24, 813 72, Bratislava, Slovakia

    Pavol Janega

  4. Faculty of Medicine, Comenius University in Bratislava, Heydukova 10, 812 50, Bratislava, Slovakia

    Viera Lehotska

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  1. Andrej Klepanec
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  2. Dusan Salat
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  8. Pavol Janega
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  9. Lenka Janosikova
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  10. Viera Lehotska
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Correspondence to Viera Lehotska.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors. The study was approved by Institutional Review Board (IRB).

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For this type of study, informed consent is not required. This study has obtained IRB approval from University Hospital Trnava, and the need for informed consent was waived.

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Klepanec, A., Salat, D., Harsany, J. et al. Neurointerventionalist and Patient Radiation Doses in Endovascular Treatment of Acute Ischemic Stroke. Cardiovasc Intervent Radiol 43, 604–612 (2020). https://doi.org/10.1007/s00270-020-02412-w

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  • DOI: https://doi.org/10.1007/s00270-020-02412-w

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