Find in Library
Search millions of books, articles, and more
Indexed Open Access Databases
Radiation Exposure and Contrast Agent Use during Endovascular Aortic Repair Using Mobile Versus Fixed Angiography Systems
oleh: Amir Arnautovic, Waseem Garabet, Reinhold Thomas Ziegler, Joscha Mulorz, Sönke Maximilian Braß, Alexander Oberhuber, Hubert Schelzig, Markus Udo Wagenhäuser, Philip Dueppers
Format: | Article |
---|---|
Diterbitkan: | MDPI AG 2024-02-01 |
Deskripsi
Background: For (thoracic) endovascular aortic repair ((T)EVAR) procedures, both mobile (standard operating room (SOR)) and fixed C-arm (hybrid operating room (HOR)) systems are available. This study evaluated differences in key procedural parameters, and procedural success for (T)EVAR in the SOR versus the HOR. Methods: All patients who underwent standard elective (T)EVAR at the Clinic for Vascular and Endovascular Surgery at the University Hospital Duesseldorf, Germany, between 1 January 2012 and 1 January 2019 were included. Data were retrieved from archived medical records. Endpoints were analyzed for SOR versus HOR during (T)EVAR. Results: A total of 93 patients, including 50 EVAR (SOR (<i>n</i> = 20); HOR (<i>n</i> = 30)) and 43 TEVAR (SOR (<i>n</i> = 22); HOR (<i>n</i>= 21)) were included. The dose area product (DAP) for EVAR and TEVAR was lower in the SOR than in the HOR (EVAR, SOR: 1635 ± 1088 cGy·cm<sup>2</sup>; EVAR, HOR: 7819 ± 8928 cGy·cm<sup>2</sup>; TEVAR, SOR: 8963 ± 34,458 cGy·cm<sup>2</sup>; TEVAR, HOR: 14,591 ± 11,584 cGy·cm<sup>2</sup> (<i>p</i> < 0.05)). Procedural fluoroscopy time was shorter in the SOR than in the HOR for EVAR and TEVAR (EVAR, SOR: 7 ± 4 min; EVAR, HOR: 18.8 ± 11.3 min; TEVAR, SOR: 6.6 ± 9.6 min; TEVAR, HOR: 13.9 ± 11.8 min (<i>p</i> < 0.05)). Higher volumes of contrast agent were applied during EVAR and TEVAR in the SOR than in the HOR (EVAR, SOR: 57.5 ± 20 mL; EVAR: HOR: 33.3 ± 5 mL (<i>p</i> < 0.05); TEVAR; SOR: 71.5 ± 53.4 mL, TEVAR, HOR: 48.2 ± 27.5 mL (<i>p</i> ≥ 0.05). Conclusion: The use of a fixed C-arm angiography system in the HOR results in higher radiation exposure and longer fluoroscopy times but lower contrast agent volumes when compared with mobile C-arm systems in the SOR. Because stochastic radiation sequelae are more likely to be tolerated in an older patient population and, in addition, there is a higher incidence of CKD in this patient population, allocation of patients to the HOR for standard (T)EVAR seems particularly advisable based on our results.