Radiation hand exposure during restoration of flow to the thrombosed dialysis access graft.
OBJECTIVE
To determine radiation dose to the hands of interventional radiologists during restoration of flow to thrombosed dialysis access grafts.


METHODS
Sixty-two procedures were performed in 54 patients with thrombosed synthetic arteriovenous hemodialysis access grafts. For each procedure, five staff interventional radiologists wore thermoluminescent ring dosimeters on each hand. Overall hand doses were obtained, and patient and graft factors as well as technical factors were analyzed to determine the effects on hand exposure.


RESULTS
The mean right hand and left hand exposures were 0.78 mSv and 0.55 mSv (78 and 55 mrem), respectively, and there was a significant difference between the two (P = .01). There was a significant difference among the interventionalists, mostly based on the lower doses associated with a single operator (P < .01). Not unexpectedly, fluoroscopy times (P < .01) and, to a lesser degree, the number of angiographic runs (P = .05) were significant factors influencing hand radiation dose. Patient sex, age and location of the graft, previous thrombosis, the number of previous interventions, and success or failure of the procedure were not significant factors in hand dose.


CONCLUSIONS
Hand exposure during the restoration of flow to thrombosed dialysis access grafts is relatively high and is greater for the right hand than for the left. The exposures are dependent on technical factors, most notably fluoroscopy times, not on patient- or graft-related factors.
Stavas
Joseph M
JM
Department of Radiology, Duke University Medical Center, Room 1502, Erwin Road, Durham, NC 27710, USA.
Smith
Tony P
TP
DeLong
David M
DM
Miller
Michael J
MJ
Suhocki
Paul V
PV
Newman
Glenn E
GE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000528:radiation effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D011829:Radiation Dosage; D015642:Radiology, Interventional; D006435:Renal Dialysis / Q000379:methods*; D013927:Thrombosis / Q000209:etiology*