The impact of radiation dose exposure during endovascular aneurysm repair on patient safety.
OBJECTIVE
Endovascular aneurysm repair (EVAR) exposes patients to radiation during the procedure and in subsequent follow-up. The study goal was to calculate the radiation dose in our unit and compare it against other published data and national guidelines.


METHODS
All EVAR procedures were identified from a prospectively maintained database. Radiation dose, screening time, and volume of intravenous contrast during the procedure were reviewed. Radiation exposure from subsequent computed tomography (CT) imaging was included in the overall exposure. Results are expressed as mean +/- standard deviation.


RESULTS
From October 1998 to October 2008, 320 elective patients underwent EVAR. Mean screening time was 29.4 +/- 23.3 minutes, and the radiation dose was 11.7 +/- 7.1 mSv. The EVAR was an emergency in 64 patients. The mean screening time was 22.9 +/- 18.2 minutes, and the radiation dose was 13.4 +/- 8.6 mSv. During the first postoperative year, follow-up CT scans exposed the patients to 24.0 mSv, with 8.0 mSv in subsequent years. Abdominal radiographs added an additional 1.8 mSv each year.


CONCLUSIONS
EVAR and the follow-up investigations involve substantial amounts of radiation, with well-recognized carcinogenic risks. Because patient safety is paramount, radiation exposure should be minimized. This may be possible by standardizing radiation exposure throughout the United Kingdom by implementing national guidelines and considering other imaging modalities for follow-up.
Jones
Claire
C
Vascular and Endovascular Surgery Unit, Belfast City Hospital, Belfast, Ireland. cjones82@hotmail.co.uk
Badger
Stephen A
SA
Boyd
Christopher S
CS
Soong
Chee V
CV
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D001027:Aortography / Q000009:adverse effects / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation; D003287:Contrast Media; D017558:Elective Surgical Procedures; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D009660:Northern Ireland; D017410:Practice Guidelines as Topic; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology*; D015641:Radiography, Interventional / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*; D016896:Treatment Outcome
D003287:Contrast Media