title: Anatomic and procedural determinants of fluoroscopy time during elective endovascular aortic aneurysm repair.
abstract: OBJECTIVE
  To identify both the procedural and anatomic factors which determine duration of fluoroscopy during elective endovascular aortic aneurysm repair (EVAR).
  
  
  METHODS
  We retrospectively analyzed our prospectively maintained EVAR database for the relationship between fluoroscopy time and both procedural (type of graft, configuration, number of components, surgeon) and anatomic factors reflective of aneurysm complexity (15 variables).
  
  
  RESULTS
  A total of 128 patients underwent elective EVAR with a mean fluoroscopy time of 5.7 ± 3.4 min. The type of grafts used consisted of 41 (32%) Zenith, 85 (66.4%) Endurant and 2 (1.6%) Anaconda, with 105 (82%) being bifurcated and 23 (18%) being aorto-uni-iliac (AUI) in configuration. Both the surgeon performing the procedure (p = 0.001) and graft configuration (bifurcated vs. AUI, p = 0.03) were found to be predictive of fluoroscopy time; while procedural and anatomic variables were not.
  
  
  CONCLUSIONS
  The surgeon's efficiency in the use of fluoroscopy during EVAR is the most important determinant of total fluoroscopy time. Anatomic complexity, make of device, and number of components inserted have minimal impact on duration of fluoroscopy. An endovascular surgeon's ability to curtail fluoroscopy duration is the key component in minimizing radiation exposure to both the surgical team and the patient.
authors: Division of Vascular Surgery, London Health Sciences Centre & Western University, London, ON, Canada.
authors: Ricardo
authors: R
authors: Ruz
authors: Division of Vascular Surgery, London Health Sciences Centre & Western University, London, ON, Canada.
authors: Kevin
authors: K
authors: Lee
authors: Division of Vascular Surgery, London Health Sciences Centre & Western University, London, ON, Canada.
authors: Adam H
authors: AH
authors: Power
authors: Division of Vascular Surgery, London Health Sciences Centre & Western University, London, ON, Canada.
authors: Guy
authors: G
authors: DeRose
authors: Division of Vascular Surgery, London Health Sciences Centre & Western University, London, ON, Canada.
authors: Thomas L
authors: TL
authors: Forbes
authors: Division of Vascular Surgery, London Health Sciences Centre & Western University, London, ON, Canada Department of Epidemiology and Biostatistics, Western University, London, ON, Canada Luc.Dubois@lhsc.on.ca.
authors: Luc
authors: L
authors: Dubois
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D001027:Aortography / Q000009:adverse effects / Q000379:methods*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D002983:Clinical Competence; D016208:Databases, Factual; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D061646:Operative Time; D011474:Prosthesis Design; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D066231:Surgeons; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D016896:Treatment Outcome
keywords: EVAR; aneurysm; fluoroscopy; radiation