PS194. Radiation Dose Optimization for Endovascular Aneurysm Repair (EVAR)

Abstract

incidence to be understated. In this ongoing study we compared the incidence of arrhythmias using two different monitoring devices.Methods: Patients with sinus rhythm were monitored with a 72-hour Holter electrocardiography device (Holter-ECG) (N ϭ 350), and combined with a subcutaneously implanted cardiac loop recorder (Reveal XT®) (N ϭ 20), the latter starting one month prior to surgery, until it was explanted one month post-surgery. New-onset arrhythmias were noted. Thirty-day postoperative events, defined as MI, stroke, and cardiac death, were noted.Results: New-onset perioperative arrhythmias were recorded in 45 (13%) and 8 (40%) patients with Holter-ECG and Reveal respectively. In patients with perioperative arrhythmias, cardiovascular events occurred more frequently (OR 3.0, 95% CI 1.4-6.4). Using the Reveal device 4 additional patients were identified who experienced perioperative cardiovascular events. The incidence of cardiovascular events with Holter and Reveal monitoring was 11/45 (24%) and 4/8 (50%) respectively.Conclusions: Vascular surgery patients may develop paroxysmal arrhythmias outside the recording window of the 72-hour Holter ECG and are generally asymptomatic. Continuous implanted cardiac monitors can detect these paroxysmal episodes of arrhythmias, which in turn could have important therapeutic consequences.

Meta-analysis of Cumulative Radiation Duration and Dose During EVAR Using Mobile, Fixed, or Fixed/3D Fusion C-Arms

“…Of 52 full-text publications examined (Figure 1), 22 articles 1,13 -33 were excluded based on exclusion criteria and an additional 3 articles 34-36 that could not be assigned to an equipment group because 2 articles 34,35 failed to report the type of C-arm (mobile or fixed) and 1 article 36 reported only the primary outcomes for a mixed group use of mobile and fixed C-arms. These latter 3 studies were excluded from the meta-analysis but were included in the overall correlation plot between FT and KAP (Supplementary Table S1; supplementary material available at http://jet.sagepub.com/content/by/supplemental-data).…”

Measurement and Optimization of Patient Radiation Doses in Endovascular Aneurysm Repair

“…The dose matrix (Table 5), which combines clinical and phantom data to show how patient dose can vary at each procedure step has the potential to be used as a training aid. 25 The EVAR procedure is broken into 15 steps. The trainee selects fluoroscopy or digital acquisition, what magnification is used, and their time estimate for each procedure step.…”