title: The impact of radiological equipment on patient radiation exposure during endovascular aortic aneurysm repair.
abstract: OBJECTIVE
  To compare the patient radiation dose during endovascular aortic aneurysm repair (EVAR) using different types of radiological systems: a mobile fluoroscopic C-arm, mobile angiographic and fixed angiographic equipment.
  
  
  METHODS
  Dose-area products (DAP) were obtained from a retrospective study of 147 consecutive patients, subjected to 153 EVAR procedures during a 3.5-year period. On the basis of these data, entrance surface dose (ESD) and effective dose (ED) were calculated. EVARs were performed using a fluoroscopic C-arm, mobile or fixed angiographic equipment in 79, 26 and 48 procedures, respectively.
  
  
  RESULTS
  Fluoroscopy times were essentially equivalent for all the systems, ranging from 15 to 19 min. The clinical outcomes were not significantly different among the systems. Statistically significant differences among radiological equipment grouping were found for DAP (mobile C-arm: 32 ± 20 Gy cm(2); mobile angiography: 362 ± 164 Gy cm(2); fixed angiography: 464 ± 274 Gy cm(2); P < 10(-6)), for ESD (mobile C-arm: 0.18 ± 0.11 Gy; mobile angiography: 2.0 ± 0.8 Gy; fixed angiography: 2.5 ± 1.5 Gy; P < 10(-6)) and ED (mobile C-arm: 6.2 ± 4.5 mSv; mobile angiography: 64 ± 26 mSv; fixed angiography: 129 ± 76 mSv; P < 10(-6)).
  
  
  CONCLUSIONS
  Radiation dose in EVAR is substantially less with a modern portable C-arm than with a fixed or mobile dedicated angiographic system.
  
  
  CONCLUSIONS
  • Fluoroscopy during endovascular aortic aneurysm repair can impart a substantial radiation dose.                                                     • Radiation doses during EVAR are higher when using mobile/fixed angiographic systems.                                                     • Mobile C-arm fluoroscopy imparts a lower dose with an equivalent clinical outcome.                                                     • Procedures need to be dose-optimised when using mobile/fixed angiographic systems.
authors.affiliation: Radiology Department, University Hospital Maggiore della Carità, Novara, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Fossaceca
authors.forename: Marco
authors.initials: M
authors.lastname: Brambilla
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guzzardi
authors.forename: Paolo
authors.initials: P
authors.lastname: Cerini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Renghi
authors.forename: Serena
authors.initials: S
authors.lastname: Valzano
authors.forename: Piero
authors.initials: P
authors.lastname: Brustia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Carriero
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002138:Calibration; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D011874:Radiometry / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome