Surgeon education decreases radiation dose in complex endovascular procedures and improves patient safety

Abstract

Surgeon education on the appropriate use of technical factors during FGIs improved operating practice, reduced patient radiation dose, and decreased the number of non-FEVAR cases that exceeded 6 Gy. It is essential that vascular surgeons be educated in best operating practices to lower PSD; nonetheless, FEVAR remains a high-dose procedure.

Surgeon radiation dose during complex endovascular procedures

“…This is because FEVARs are complex procedures that often involve acute gantry angulations and prolonged operative time and have been shown to generate higher RAK and KAP levels compared with other endovascular procedures. 1 Our operator exposure doses during FEVARs were slightly They also noted significant variability, with the most experienced operator receiving an average dose of 68 mSv and more junior interventionalists receiving 172 mSV per FEVAR. All the FEVARs in this series were performed by one experienced interventionalist, and therefore no variations of dose from learning curves were seen.…”

“…1,15 This study was limited because we did not control for either variable. This led to the high observed variability within procedure types and large error bars on the regression coefficients.…”

“…FGIs are increasing not only in number but also in complexity, thus requiring higher radiation doses to complete. 1 Vascular surgeons routinely performing FGIs as well as their patients are at risk of significant exposure to ionizing radiation and the associated harmful deterministic and stochastic effects. 2 Most personnel dosimeters are read monthly to ensure that surgeons and operating room staff exposures remain below the limits established by the International Commission on Radiological Protection.…”

“…2,4 The RAK offers an estimate of the air kerma at the approximate entry point of the patient's skin and therefore is the best approximation of the patient's skin dose. 1,5 KAP is a measure of the total X-ray energy output of the X-ray tube and therefore a good approximation of the total X-ray energy absorbed by the patient. KAP has been shown to be a better predictor of operator dose and stochastic risk to both patient and operator compared with RAK.…”

Occupational Radiation Exposure During Endovascular Aortic Repair

“…The increasing number of endovascular interventions for aortic pathology, particularly in challenging anatomies, results in increasing radiation exposure to operating room personnel [1][2][3]. Endovascular aortic repair procedures are frequently performed at hybrid operating rooms, where also staff members may be present who are not sufficiently educated in radiobiology, radiation safety, and dose reduction principles [4,5]. Characterization of occupational radiation exposure for operators and supporting staff involved in these procedures therefore is of great interest.…”