A. Widmark. , L. E. Staxrud. , E. G. Friberg. , T. Gjølberg. , D. Bay

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Presentation transcript:

Endovascular treatment of abdominal aortic aneurysms (AAA): What about the doses? A. Widmark*, L.E. Staxrud**, E.G. Friberg*, T. Gjølberg***, D. Bay***, J.J. Jørgensen** *Norwegian Radiation Protection Authority, **Oslo Vascular Center, ***Radiological department, Aker sykehus 6th European ALARA Workshop

Introduction Increase survival rate and quality of life Potential high doses to both patients and staff [mGy] 8 patients

Material and methods 8 patients and procedures Sometimes need for limb exstensions to external arteries Operating theatre designed as an angiographic laboratory

Patients Dose registrations Dose-areal product (DAP) Number of exposures Fluoroscopy time Max. skin dose measured with Thermoluminescent dosimeter (TLD) (n=4)

Operators TLD ring dosimeters under the surgical gloves Well experienced with the stent-graft technique Surgeons received basic training before study

Results I ] Dose-area product [Gycm Fluoroscopy time [min] 50 100 150 200 250 300 350 400 1 2 3 4 5 6 7 8 Patient no. Dose-area product [Gycm ] 10 20 30 40 60 70 Fluoroscopy time [min] DAP - Fluoroscopy DAP - Exposures Fluoroscopy time 457 exp. 283 exp. 210 exp. 209 exp. 350 exp. 168 exp. 407 exp. 374 exp. Patient 3, 4 and 6 - 0 graft limb extension Patient 2, 5 and 8 - 1 graft limb extension Patient 1 and 7 - 2 graft limb extensions

Results II Patient average values ESD [Gy] Effective dose [mSv] No. of exposures 1,8 (1,4-2,3) 50 (22-64) 307 (168-457)

Results IV Finger doses [mGy] to the operators Surgeons (n=6) Left Right 54 (20-90) 111 (20-260) Radiologists (n=8) Left Right 283 (82-876) 169 (53-401) Total average 170 mGy

Conclusions Endovascular treatment of AAA can cause deterministic injuries on patient. The radiation dose to the operator can be low with a good working technique. No correlation between finger dose and patient ESD, DAP or fluoroscopy time Access for Radiation Protection Officers to surgical forums important A good working technique is much dependent on competence, but that is not sufficient. An appropriate conduct and attitude to radiation protection is of great importance.