title: Occupational radiation dose: percutaneous interventional procedures on hemodialysis arteriovenous fistulas and grafts.
abstract: OBJECTIVE
  To evaluate operator radiation exposure during percutaneous interventions on hemodialysis arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs).
  
  
  METHODS
  Seventy-seven procedures were performed in 57 patients while the interventional radiologist wore two ring dosimeters, two thermoluminescent dosimeters at the lower legs, and a thermoluminescent dosimeter on the forehead. Dose-area product, fluoroscopy time, total procedure time, and radiation exposures to eye lens, hands, and legs were recorded. Variables were procedure type, access site side, and angiography equipment. Statistical analysis was performed with the signed-rank and Mann-Whitney U tests.
  
  
  RESULTS
  Mean operator radiation doses for the left hand, right hand, eye lens, left leg, and right leg were 0.28, 0.28, 0.03, 0.11, and 0.12 mSv, respectively. Radiation exposure to the hands was significantly higher compared with that to the legs (P<.0001). In recanalization procedures, fluoroscopy time, total procedure time, and mean number of angiographic runs were higher (all P<.001) than those for percutaneous transluminal angioplasty (PTA), as were radiation exposures to the hands and left leg (all P<.05). Left-sided access interventions resulted in higher doses to the right hand and leg (both P<.05). For right-sided access interventions, doses to the left hand and leg were higher (P<.0001). Eye lens radiation dose was significantly higher for procedures with the flat-panel detector system (P=.002).
  
  
  CONCLUSIONS
  Operator radiation exposure to the hands, legs, and eyes during percutaneous interventional procedures performed on hemodialysis AVFs and AVGs is relatively low. Radiation exposure to the hands was higher than that to the legs, and the hand and leg closest to the AVF or AVG received a higher dose. Recanalization procedures resulted in higher doses to the hands and left leg than did PTA. Eye lens radiation dose may be higher with a flat-panel detector system.
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. sam.heye@uzleuven.be
authors.forename: Sam
authors.initials: S
authors.lastname: Heye
authors.forename: Geert
authors.initials: G
authors.lastname: Maleux
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Oyen
authors.forename: Kathleen
authors.initials: K
authors.lastname: Claes
authors.forename: Dirk R J
authors.initials: DR
authors.lastname: Kuypers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011829:Radiation Dosage; D011835:Radiation Protection; D015641:Radiography, Interventional; D006435:Renal Dialysis; D018709:Statistics, Nonparametric; D013819:Thermoluminescent Dosimetry; D014963:X-Ray Intensifying Screens