Yunsun Song1, Seongsik Han2, Byung Jun Kim3, Seong Heum Oh2, Jin Su Kim2, Tae Il Kim2, Deok Hee Lee4. 1. Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. 2. Department of Radiologic Technology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. 3. Advanced Therapies, Siemens Healthineers Ltd, Seoul, South Korea. 4. Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. dhlee@amc.seoul.kr.
Abstract
BACKGROUND: Among neurointerventional procedures, the embolization of complex shunt lesions usually requires more radiation dose. We aimed to evaluate the procedural outcome and safety in using low-dose DSA protocols for intracranial dural arteriovenous fistula (AVF) embolization treatment. METHODS: Between January 2014 and July 2018, 55 patients with dural AVFs who underwent endovascular treatment were included in the study. The low-dose group (n = 27) included from January 2016 used various low-dose DSA protocols made by modifying the thickness of the copper filter or the detector entrance dose. We compared radiation dose metrics, such as air-kerma, kerma-air product (KAP), and fluoroscopy time, as well as clinical and imaging outcomes with the conventional-dose group (n = 28) included before January 2016. RESULTS: The total KAP was 40.1% lower in the low-dose group (87.9 vs. 146.7 Gy cm2, p = 0.002). The average number of DSA runs (25.1 vs. 25.5, p = 0.86) and fluoroscopy times (77.4 vs. 69.7 min, p = 0.48) were similar between the groups. An immediate favorable occlusion rate (total or near total occlusion) was achieved in 41 (74.5%) patients. Ten patients (18.2%) underwent additional procedures due to residual (n = 6) and/or recurrent (n = 5) lesions. At a median of 10 months follow-up, 45 patients (86.5%) had achieved favorable occlusion. Treatment outcomes showed no significant between-group differences. There was one case (1.8%) of procedure-related complications in the low-dose group. All but one patient showed favorable clinical outcomes (modified Rankin score ≤ 2). CONCLUSION: The low-dose protocols were feasible by showing significant radiation dose reduction and acceptable procedural outcome.
BACKGROUND: Among neurointerventional procedures, the embolization of complex shunt lesions usually requires more radiation dose. We aimed to evaluate the procedural outcome and safety in using low-dose DSA protocols for intracranial dural arteriovenous fistula (AVF) embolization treatment. METHODS: Between January 2014 and July 2018, 55 patients with dural AVFs who underwent endovascular treatment were included in the study. The low-dose group (n = 27) included from January 2016 used various low-dose DSA protocols made by modifying the thickness of the copper filter or the detector entrance dose. We compared radiation dose metrics, such as air-kerma, kerma-air product (KAP), and fluoroscopy time, as well as clinical and imaging outcomes with the conventional-dose group (n = 28) included before January 2016. RESULTS: The total KAP was 40.1% lower in the low-dose group (87.9 vs. 146.7 Gy cm2, p = 0.002). The average number of DSA runs (25.1 vs. 25.5, p = 0.86) and fluoroscopy times (77.4 vs. 69.7 min, p = 0.48) were similar between the groups. An immediate favorable occlusion rate (total or near total occlusion) was achieved in 41 (74.5%) patients. Ten patients (18.2%) underwent additional procedures due to residual (n = 6) and/or recurrent (n = 5) lesions. At a median of 10 months follow-up, 45 patients (86.5%) had achieved favorable occlusion. Treatment outcomes showed no significant between-group differences. There was one case (1.8%) of procedure-related complications in the low-dose group. All but one patient showed favorable clinical outcomes (modified Rankin score ≤ 2). CONCLUSION: The low-dose protocols were feasible by showing significant radiation dose reduction and acceptable procedural outcome.
Authors: Amir R Honarmand; Ali Shaibani; Tamila Pashaee; Furqan H Syed; Michael C Hurley; Christina L Sammet; Matthew B Potts; Babak S Jahromi; Sameer A Ansari Journal: J Neurointerv Surg Date: 2016-04-06 Impact factor: 5.836
Authors: Yon Kwon Ihn; Bum-Soo Kim; Jun Soo Byun; Sang Hyun Suh; Yoo Dong Won; Deok Hee Lee; Byung Moon Kim; Young Soo Kim; Pyong Jeon; Chang-Woo Ryu; Sang-Il Suh; Dae Seob Choi; See Sung Choi; Jin Wook Choi; Hyuk Won Chang; Jae-Wook Lee; Sang Heum Kim; Young Jun Lee; Shang Hun Shin; Soo Mee Lim; Woong Yoon; Hae Woong Jeong; Moon Hee Han Journal: Neurointervention Date: 2016-09-03