title: Occupational Radiation Exposure During Endovascular Aortic Repair.
abstract: OBJECTIVE
  The aim of the study was to evaluate the radiation exposure to operating room personnel and to assess determinants for high personal doses during endovascular aortic repair.
  
  
  METHODS
  Occupational radiation exposure was prospectively evaluated during 22 infra-renal aortic repair procedures (EVAR), 11 thoracic aortic repair procedures (TEVAR), and 11 fenestrated or branched aortic repair procedures (FEVAR). Real-time over-lead dosimeters attached to the left breast pocket measured personal doses for the first operators (FO) and second operators (SO), radiology technicians (RT), scrub nurses (SN), anesthesiologists (AN), and non-sterile nurses (NSN). Besides protective apron and thyroid collar, no additional radiation shielding was used. Procedural dose area product (DAP), iodinated contrast volume, fluoroscopy time, patient's body weight, and C-arm angulation were documented.
  
  
  RESULTS
  Average procedural FO dose was significantly higher during FEVAR (0.34 ± 0.28 mSv) compared to EVAR (0.11 ± 0.21 mSv) and TEVAR (0.06 ± 0.05 mSv; p = 0.003). Average personnel doses were 0.17 ± 0.21 mSv (FO), 0.042 ± 0.045 mSv (SO), 0.019 ± 0.042 mSv (RT), 0.017 ± 0.031 mSv (SN), 0.006 ± 0.007 mSv (AN), and 0.004 ± 0.009 mSv (NSN). SO and AN doses were strongly correlated with FO dose (p = 0.003 and p < 0.001). There was a significant correlation between FO dose and procedural DAP (R = 0.69, p < 0.001), iodinated contrast volume (R = 0.67, p < 0.001) and left-anterior C-arm projections >60° (p = 0.02), and a weak correlation with fluoroscopy time (R = 0.40, p = 0.049).
  
  
  CONCLUSIONS
  Average FO dose was a factor four higher than SO dose. Predictors for high personal doses are procedural DAP, iodinated contrast volume, and left-anterior C-arm projections greater than 60°.
authors.affiliation: Department of Radiology, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands, anni.sailer@mumc.nl.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Sailer
authors.forename: Geert Willem H
authors.initials: GW
authors.lastname: Schurink
authors.forename: Martine E
authors.initials: ME
authors.lastname: Bol
authors.forename: Michiel W
authors.initials: MW
authors.lastname: de Haan
authors.forename: Willem H
authors.initials: WH
authors.lastname: van Zwam
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Cécile R L P N
authors.initials: CR
authors.lastname: Jeukens
mesh_terms: D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D011834:Radiation Monitoring / Q000706:statistics & numerical data*; D015641:Radiography, Interventional / Q000706:statistics & numerical data