Maria Antonella Ruffino1, Marco Fronda2, Andrea Discalzi1, Paola Isoardi3, Laura Bergamasco4, Roberto Ropolo3, Dorico Righi1, Paolo Fonio5. 1. Department of Diagnostic Imaging and Radiotherapy - Vascular Radiology, San Giovanni Battista Hospital, Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Turin, Italy. 2. Department of Surgical Sciences - Radiology Unit, University of Torino, Turin, Italy. marco.fronda87@gmail.com. 3. Department of Diagnostic Imaging and Radiotherapy - Health Physics, Città della Salute e della Scienza di Torino, Turin, Italy. 4. Department of Surgical Sciences, Città della Salute e della Scienza di Torino, Turin, Italy. 5. Department of Surgical Sciences - Radiology Unit, University of Torino, Turin, Italy.
Abstract
PURPOSE: To evaluate the radiation dose reduction during endovascular aneurysm repair (EVAR) after the reconfiguration of a Philips AlluraXper FD20 X-ray system. METHODS: Between 2013 and 2015, we implemented a low-dose protocol (Eco dose) increasing the filtration with 1 mm of Al and 0.1 of Cu on both fluoroscopy and fluorography and halving the frames per second in fluoroscopy. The switch was complemented by hybrid operating room staff education and training in radiation protection. We compared two samples of 50 patients treated before the switch (normal dose) with 50 patients treated after the switch (Eco dose). Procedures were categorized into two different grades of complexity, standard and complex, intended as fenestrated/chimney/snorkel and EVAR plus additional embolization to prevent endoleak type II. We evaluated patient demographics, Air Kerma (AK), dose area product (DAP), and procedural data (fluoroscopy time, number of fluorographies, and iodinated contrast). Staff radiation dose was measured with film badge dosimeter on C-arm. RESULTS: The Eco-dose protocol witnessed a DAP reduction of 53% in standard EVARs and of 57% in complex EVARs and an AK reduction of 45% in standard and 57% in complex EVAR. The image quality in 2016 was perceived acceptable, as proven by the fact that fluoroscopy time, number of fluorographies, and contrast medium volumes did not have to be increased. We achieved a reduction in staff dose of 25.6%. CONCLUSIONS: Optimized angiographic system setting significantly reduced the radiation dose both to the patients and to the staff assuring safe EVAR procedures.
PURPOSE: To evaluate the radiation dose reduction during endovascular aneurysm repair (EVAR) after the reconfiguration of a Philips AlluraXper FD20 X-ray system. METHODS: Between 2013 and 2015, we implemented a low-dose protocol (Eco dose) increasing the filtration with 1 mm of Al and 0.1 of Cu on both fluoroscopy and fluorography and halving the frames per second in fluoroscopy. The switch was complemented by hybrid operating room staff education and training in radiation protection. We compared two samples of 50 patients treated before the switch (normal dose) with 50 patients treated after the switch (Eco dose). Procedures were categorized into two different grades of complexity, standard and complex, intended as fenestrated/chimney/snorkel and EVAR plus additional embolization to prevent endoleak type II. We evaluated patient demographics, Air Kerma (AK), dose area product (DAP), and procedural data (fluoroscopy time, number of fluorographies, and iodinated contrast). Staff radiation dose was measured with film badge dosimeter on C-arm. RESULTS: The Eco-dose protocol witnessed a DAP reduction of 53% in standard EVARs and of 57% in complex EVARs and an AK reduction of 45% in standard and 57% in complex EVAR. The image quality in 2016 was perceived acceptable, as proven by the fact that fluoroscopy time, number of fluorographies, and contrast medium volumes did not have to be increased. We achieved a reduction in staff dose of 25.6%. CONCLUSIONS: Optimized angiographic system setting significantly reduced the radiation dose both to the patients and to the staff assuring safe EVAR procedures.
Authors: Michael S Stecker; Stephen Balter; Richard B Towbin; Donald L Miller; Eliseo Vañó; Gabriel Bartal; J Fritz Angle; Christine P Chao; Alan M Cohen; Robert G Dixon; Kathleen Gross; George G Hartnell; Beth Schueler; John D Statler; Thierry de Baère; John F Cardella Journal: J Vasc Interv Radiol Date: 2009-07 Impact factor: 3.464
Authors: Melissa L Kirkwood; Jeffrey B Guild; Gary M Arbique; Shirling Tsai; J Gregory Modrall; Jon A Anderson; John Rectenwald; Carlos Timaran Journal: J Vasc Surg Date: 2016-07-26 Impact factor: 4.268
Authors: T Gregory Walker; Sanjeeva P Kalva; Suvranu Ganguli; Rahmi Öklü; Gloria M Salazar; Arthur C Waltman; Stephan Wicky Journal: AJR Am J Roentgenol Date: 2012-01 Impact factor: 3.959
Authors: Kenneth A Fetterly; Verghese Mathew; Ryan Lennon; Malcolm R Bell; David R Holmes; Charanjit S Rihal Journal: JACC Cardiovasc Interv Date: 2012-08 Impact factor: 11.195