title: Effects of low-dose protocols in endovascular treatment of intracranial aneurysms: development of workflow task analysis during cerebral endovascular procedures.
abstract: OBJECTIVE
  Reducing radiation exposure through the use of low-dose protocols during cerebral endovascular procedures is recommended, but evaluation of the impact on the procedure itself is difficult and subjective. A workflow task analysis could provide an objective comparison of two different radiation exposure protocols.
  
  
  METHODS
  Twenty endovascular aneurysm treatments were analyzed using a low-dose protocol (reducing radiation exposure by 20%) in 10 cases and a normal-dose protocol in the other 10 cases. The procedure was subdivided into five phases, each comprising a sequence of tasks. Each task was defined as a triplet, associating an action, an instrument, and an anatomic structure. A workflow editor was used to record tasks and phases with a tablet PC. The total duration of the entire procedure, the duration of each task, and the number of task repetitions were isolated and used as the metric. Moreover, the tasks involving x-ray use, essential for navigation and treatment phases, were separated and analyzed.
  
  
  RESULTS
  For the microcatheter navigation and treatment phases, no statistically significant difference was found between the two radiation exposure protocols. For guide catheter navigation in cervical vessels, the total phase duration and total and mean time of tasks specifically involving x-ray use increased with age, but there was no difference between the two radiation protocols.
  
  
  CONCLUSIONS
  Workflow task analysis of endovascular aneurysm treatment shows no difference between low-dose and normal-dose protocols in the guide catheter navigation, microcatheter navigation, or treatment phases.
authors.affiliation: Department of Radiology, Brest University Hospital, Blvd Tanguy Prigent, Brest 29200, France. jcgentric@gmail.com
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Gentric
authors.forename: Pierre
authors.initials: P
authors.lastname: Jannin
authors.forename: Brivael
authors.initials: B
authors.lastname: Trelhu
authors.forename: Laurent
authors.initials: L
authors.lastname: Riffaud
authors.forename: Hélène
authors.initials: H
authors.lastname: Raoult
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Ferré
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Gauvrit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D057510:Endovascular Procedures; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D018709:Statistics, Nonparametric; D013647:Task Performance and Analysis