Endovascular Intervention with a Mobile C-Arm in the Operating Room

Abstract

Mobile C-arm fluoroscopic X-ray systems are used for various diagnostic imaging and minimally invasive endovascular procedures. One of the greatest advantages of a mobile C-arm is its ability to move around the patient. The purpose of this study was to address the optimal setting of the mobile C-arm and the operating table, as well as the proper position of the operator and assistants for each procedure. In addition, methods to minimize radiation exposure to the operator and medical staff are described. Both the optimal setting and the proper position were classified by 5 types. These include the setting for aortic and inferior vena caval procedures (type I); left lower extremity (LE) intervention with an up-and-over technique (type II); right LE intervention with up-and-over technique, or bilateral LE vascular intervention with antegrade access (type III); arteriovenous fistula/graft intervention (type IV); and central vein catheterization (type V).

Análise da aplicabilidade do arco em C no centro cirúrgico em conjunto com a proteção radiológica: Uma revisão integrativa da literatura

“…Dentro de uma sala de cirurgia, esses equipamentos estão presentes em diversos procedimentos dentro da Urologia, Cardiologia, Neurologia e principalmente da Ortopedia. A fluoroscopia mostra-se muito útil no Bloco Operatório e nas Salas de Intervenção, pois é necessário existir uma versatilidade de funcionalidades de aquisição de imagens [9].…”

Low-dose pulsed vs standard pulsed fluoroscopy during ERCP to reduce radiation without change in image quality: Prospective randomized study

“…Based on previous fluoroscopy studies, a sample-size calculation before the initiation of the study identified a requirement of 40 patients per group to measure a 20% difference in mean imaging quality with a power of 0.80 Given the expectation of a 5% difference, we exceeded the calculated sample-size calculation required to account for incomplete or missing data and projected patient withdrawal from study protocol 15 16 17 18 19 20 21 22 23 24 25 26 27 28 .…”

“…Additionally, newer fluoroscopy equipment provides options to limit radiation delivery in the form of lower radiation dose and frame rate or time-limited "pulsed" settings. Pulsed settings have been utilized and have demonstrated successful reduction in RE in many fields including orthopedics, neurosurgery, anesthesia, interventional radiology, vascular surgery, urology, and cardiology [15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The angle or positioning of the C-arm has been shown to impact the level of radiation to the surgeon, and lung and colon cancers appear to be of greatest risk to surgeon [29].…”

“…In addition, newer fluoroscopy equipment provides options to limit radiation delivery in the form of lower radiation dose and frame rate or time-limited “pulsed” settings. Pulsed settings have been utilized and have demonstrated successful reduction in RE in many fields including orthopedics, neurosurgery, anesthesia, interventional radiology, vascular surgery, urology, and cardiology 15 16 17 18 19 20 21 22 23 24 25 26 27 28 …”