Endovascular aortic sealing with Nellix reduces intraoperative radiation dose when compared to endovascular aortic repair

Autor: Mirjam Heinrich, Robert Seelos, Stefan Ockert, Thomas Kaufmann, Thomas Syburra, Ruben Lopez
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Time Factors
Aortography
Computed Tomography Angiography
Operative Time
030204 cardiovascular system & hematology
Prosthesis Design
Radiation Dosage
Effective dose (radiation)
Body Mass Index
030218 nuclear medicine & medical imaging
Blood Vessel Prosthesis Implantation
03 medical and health sciences
Kerma
0302 clinical medicine
Predictive Value of Tests
Radiation Monitoring
Risk Factors
Blood vessel prosthesis
medicine.artery
medicine
Humans
Fluoroscopy
Aorta
Aged
Retrospective Studies
medicine.diagnostic_test
business.industry
Body Weight
Endovascular Procedures
Angiography
Digital Subtraction
Radiation Exposure
Blood Vessel Prosthesis
Surgery
Treatment Outcome
Dose area product
Predictive value of tests
Female
Stents
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Vascular Surgery. 67:1068-1073
ISSN: 0741-5214
DOI: 10.1016/j.jvs.2017.07.126
Popis: Objective To analyze radiation exposure during endovascular aortic sealing (EVAS) in comparison with standard endovascular aortic repair (EVAR) in clinical practice. Methods From December 2013 to October 2016 (35 months), 60 patients were analyzed for intraoperative radiation exposure during EVAR: 30 consecutive patients (mean age, 73.10 years; 28 male) received EVAS (Nellix Endologix); within the same time frame, 30 patients were treated with standard EVAR (mean age, 71.87 years; 30 male). An indirect dose analysis was performed for both groups of patients, including effective dose and cumulative air kerma. Furthermore, fluoroscopy time (FT), dose area product, and time of procedure were included in the study. Results The effective dose was significantly reduced in the EVAS group (3.72 mSv) compared with the group treated with standard EVAR (6.8 mSv; P ≤ .001). The cumulative air kerma was also lowered in EVAS (67.65 mGy vs 139 mGy in EVAR; P ≤ .001). FT for the entire group was 13 minutes and was shorter ( P 2 and was lower during EVAS (12.4 Gy.cm 2 ) than during EVAR (22.6 Gy.cm 2 ; P P P = .022), body mass index ( P = .004), and time of procedure ( P = .005). Conclusions EVAS is associated with a relevant decrease in indirect measured radiation dose and time of procedure compared with standard EVAR. A relevant reduction in dose during EVAS is highly likely to result in lower exposure to radiation for physicians and staff. Such a result would be highly advantageous and calls for further analysis.
Databáze: OpenAIRE
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