In procedures performed on the arteries of the lower limbs, a significantly higher dose was received by patients with TASC II C lesions. With regard to the number of stents implanted, the total DAP value was 50% higher for simultaneous three-stent implantation than for one or two stents.
This article is the first investigation that studies patient doses (air kerma and DAP) during digital subtraction angiography (DSA) for stent-graft treatment of both thoracic (TAAs) and abdominal (AAAs) aortic aneurysms. Fluoroscopy and exposure time, air kerma and dose-area product (DAP) were analyzed from 100 patients. In 41% of the analyzed patients total air kerma was between 1-2 Gy and for 7% exceeded 2 Gy. Median DAP values for fluoroscopy were 87.6 (TAAs) and 142.2 (AAAs) (Gy cm2) and for exposure 364.7 and 238.7 (Gy cm2), respectively. A 10-min prolongation of treatment causes about 83 Gy cm increase of DAP for fluoroscopy and 390 Gy cm for each 1 s of exposure. A good correlation between DAP and examination times was found for both exposure (r = 0.78) and fluoroscopy (r = 0.7). Moreover, sex was found to be a differential factor for DAP: DAP values for females were about 25% lower for both clinical procedures. For this kind of treatment the radiation doses were obtained for patients. Total air kerma in this kind of treatment for TAAs might be high and can even reach 4 Gy.
SummaryBackgroundAn important negative factor of EVAR is the radiation acquired during long-lasting procedures. The aim of the study was to document the radiation doses of EVAR and to discuss potential reasons for prolongation of radiological procedures.Material/MethodsDose-area product (DAP) (Gy cm2) and air kerma (AK) (Gy) obtained during EVAR from 92 patients were analyzed retrospectively in regards to body mass index (BMI), angulations of aneurysm neck, length of aneurysm neck and occurrence of tortuosity of iliac arteries.ResultsTotal AK for fluoroscopy differed significantly between normal BMI (373 mGy) and BMI 25–29.9 (1125 mGy) or BMI >30 (1085 mGy). Iliac artery tortuosities >45° and short aneurysm necks caused higher doses of total AK (1097 mGy and 1228 mGy, respectively) than iliac artery tortuosities <45° and long aneurysm necks (605 mGy and 720 mGy, respectively).ConclusionsThe main factors contributing to a high radiation dose being acquired by patients during EVAR are: BMI >25, tortuosity of iliac arteries >45° and short aneurysm necks.
Currently the major aim in peripheral vascular malformation diagnosis, crucial for subsequent management and treatment, is to identify its haemodynamic characteristics. Other significant features that should be specified by a radiologist are the exact location of the anomaly, its size, and its morphology. Until recently the diagnostic methods available for comprehensive evaluation of malformations have been rather limited. Moreover, they were often associated with the necessity of exposing the patient to X-ray radiation and with invasive procedures, as for example in angiography. The development of imaging techniques used in the diagnosis of vascular abnormalities in recent years, especially magnetic resonance imaging, has contributed to improved diagnostic value of the tests. In this article we review the currently available imaging modalities with particular consideration of magnetic resonance imaging and its capability to distinguish between high- and low-flow malformations.
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