1. 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

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

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

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

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

6. 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 graft limb extension
Patient 2, 5 and graft limb extension
Patient 1 and graft limb extensions

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

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

9. 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.