Occupational radiation exposure during endovascular aortic procedures

Eur J Vasc Endovasc Surg. 2013 Oct;46(4):424-30. doi: 10.1016/j.ejvs.2013.05.023. Epub 2013 Jul 19.

Abstract

Objectives: To measure the radiation exposure of the operating team during endovascular aortic procedures, and to determine factors that predict high exposures.

Materials and methods: Electronic dosimeters placed over and under protective lead garments, were used to prospectively record radiation exposure during endovascular aortic repairs performed in a designated interventional radiology suite. Univariate and multivariate linear regression analyses of predictors of radiation exposure were performed.

Results: A total of 26 infra-renal and 10 thoracic endovascular cases were studied. Median (IQR) patient age and body mass index were 76.0 (70.0-81.8) years and 26.2 (23.9-28.9) kg/m(2) respectively. Over-lead exposure to the operator was higher for thoracic than for infra-renal procedures (421.0 [233.8-597.8] μSv vs. 52.5 [27.8-179.8] μSv, p = .0003), reflecting a significant exposure to unprotected parts of the body. Under-lead exposures for operator and assistant were 5.5 (2.0-14.2) μSv and 1.0 (0.0-2.3) μSv respectively, which for an average caseload would comply with total body effective dose limits. Type of case and percentage of digital subtraction angiography (DSA) time in left anterior oblique angulations predicted dose to the operator (p < .0001).

Conclusions: Thoracic procedures, DSA runs and obliquity of the C-arm are strong predictors of radiation exposure during endovascular aortic repairs. Understanding scatter radiation dynamics and instigating measures to minimise radiation exposure should be mandatory.

Keywords: Aortic repair; Dosimetry; Endovascular; Occupational radiation exposure.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction / adverse effects
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / surgery*
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery*
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / surgery*
  • Aortography / adverse effects
  • Endovascular Procedures / adverse effects*
  • Equipment Design
  • Humans
  • Linear Models
  • Multivariate Analysis
  • Occupational Exposure / adverse effects*
  • Occupational Exposure / prevention & control
  • Occupational Health
  • Prospective Studies
  • Protective Clothing
  • Radiation Dosage*
  • Radiation Injuries / etiology
  • Radiation Injuries / prevention & control
  • Radiation Monitoring
  • Radiation Protection / instrumentation
  • Radiography, Interventional / adverse effects*
  • Risk Assessment
  • Risk Factors
  • Scattering, Radiation