INTRODUCTION: Female gender is considered a risk factor for worse perioperative outcomes following Fenestrated Endovascular Aneurysm repair (FEVAR). We hypothesized that women would have more unfavorable anatomy, increasing case complexity and leading to higher radiation doses. Our aim was to evaluate the effect of gender on radiation dose during FEVARs. METHODS: This single-center retrospective study was performed from 1/2015-2/2018. For patient data, linear model and stepwise variable selection algorithm were used. All dose measurements were log-transformed before analysis. Significance level for parameter estimates and corresponding 95% confidence intervals were all transformed back using an exponential function. P-value of <0.05 was considered statistically significant. All analyses were done in SAS 9.4 (SAS Institute Inc., Cary, NC). RESULTS: 169 FEVARs (45 women) were performed on a Philips Allura Xper FD 20 fluoroscopy system equipped with clarity technology. There was no difference in BMI or operative time between genders, p=0.9. The median RAK for women was significantly lower compared to men (1672 mGy vs. 2496 mGy), p<0.001. Women had on average a 28% total dose reduction after controlling for BMI, number of vessels fenestrated, operative time and type of device, p<0.001. The median fluorography and fluoroscopy doses for women were significantly lower compared to men (973 mGy vs. 1401 mGy and 659 mGy vs. 1008 mGy), resulting in a 24% fluorography dose reduction and a 38% fluoroscopy dose reduction for females, p<0.001. CONCLUSION: FEVARs can be performed successfully in women with comparatively lower radiation doses.
INTRODUCTION: Female gender is considered a risk factor for worse perioperative outcomes following Fenestrated Endovascular Aneurysm repair (FEVAR). We hypothesized that women would have more unfavorable anatomy, increasing case complexity and leading to higher radiation doses. Our aim was to evaluate the effect of gender on radiation dose during FEVARs. METHODS: This single-center retrospective study was performed from 1/2015-2/2018. For patient data, linear model and stepwise variable selection algorithm were used. All dose measurements were log-transformed before analysis. Significance level for parameter estimates and corresponding 95% confidence intervals were all transformed back using an exponential function. P-value of <0.05 was considered statistically significant. All analyses were done in SAS 9.4 (SAS Institute Inc., Cary, NC). RESULTS: 169 FEVARs (45 women) were performed on a Philips Allura Xper FD 20 fluoroscopy system equipped with clarity technology. There was no difference in BMI or operative time between genders, p=0.9. The median RAK for women was significantly lower compared to men (1672 mGy vs. 2496 mGy), p<0.001. Women had on average a 28% total dose reduction after controlling for BMI, number of vessels fenestrated, operative time and type of device, p<0.001. The median fluorography and fluoroscopy doses for women were significantly lower compared to men (973 mGy vs. 1401 mGy and 659 mGy vs. 1008 mGy), resulting in a 24% fluorography dose reduction and a 38% fluoroscopy dose reduction for females, p<0.001. CONCLUSION: FEVARs can be performed successfully in women with comparatively lower radiation doses.