Investigation of reference levels and radiation dose associated with abdominal EVAR (endovascular aneurysm repair) procedures across several European Centres

Abstract

• Abdominal endovascular aneurysm repair (EVAR) requires the use of ionising radiation. • EVAR is a minimally invasive procedure for the treatment of abdominal aortic aneurysms. • Diagnostic reference levels (DRLs) are used to monitor patient radiation exposure. • Radiation dose data was collected from five European centres for EVAR procedures. • Local DRLs have been determined and an interim European DRL is proposed.

Radiation exposure in an endovascular aortic aneurysm repair program after introduction of a hybrid operating theater

“…Eleven studies, including this study, of 1452 patients treated with EVAR on a dedicated fixed system were included. 3,4,[16][17][18][19][20][21][22][23] Moreover, besides this study, two other studies used 3D fusion: Hertault et al 3 and Sailer et al 19 DAP results in these three studies are low, especially in the study presented by Hertault et al 3 DAP results achieved in this study were in line with the lowest DAP outcomes for standard EVAR procedures in a HOT in the literature (Table IV).…”

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

“…284 A European diagnostic reference levels has been suggested through pooled European data. 285 Operators should know and apply the ALARA ("as low as reasonably achievable") principles 286 to protect the patient and team members.…”

National Diagnostic Reference Levels for Endovascular Aneurysm Repair and Optimisation Strategies

“…But patient dose values are not as low as those obtained by Herthault et al 13 Tuthill et al have published reference levels for abdominal EVAR from a sample of 180 procedures in five European hospitals (two in Ireland and three in Italy). 15 The third quartile of KAP was 158 Gy cm 2 with a range of mean values at the different hospitals from 43 to 318 Gy cm 2 . All the Xray systems used in the survey were Siemens fixed systems.…”