A 2-year RE exceeding the threshold of 100 mSv with a life expectancy >15 years can be estimated to lead to a lifetime risk increase in radiation-induced leukaemia and solid-tumour cancer >2.7%. The risks of cumulative RE especially in younger and/or obese patients must be balanced with the expected morbidity and mortality reduction in TEVAR versus traditional open repair, and the anticipated benefits of recurrent radiographic imaging.
Results:In the 96 patient study, mean effective dose for EVAR was 12.6mSv (.23 -80.9), and mean FT was 18.8mins (.2 -64.6). Phantom studies determined patient entrance dose for selected FOV (36, 28, 20 and 14cm) as 3.65, 5.32, 8.46 and 15.6mGy/min for Flouroscopy and 1.1, 1.94, 3.15 and 3.83mGy/frame for DSA. The 7 patient study showed mean number of digital frames was 191 (100 -376) and maximum calculated skin dose was 1.3Gy, below deterministic injury threshold. Stochastic risk for EVAR and associated CT was Ͻ 1/800.Conclusions: Our data confirms a significant variation in radiation exposure during EVAR. We have combined clinical and phantom data to calculate the radiation dose per individual step. This has the potential to be used as an educational tool and to support optimization and dose reduction.
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