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Clinical factors increasing radiation doses to patients undergoing long-lasting procedures: Abdominal stent-graft implantation

Natalia Majewska, Michal G. Stanisic, Magdalena Aleksandra Blaszak, Robert Juszkat, Maciej Frankiewicz, Zbigniew Krasinski, Marcin Makalowski, Waclaw Majewski

Med Sci Monit 2011; 17(11): MT97-103

DOI: 10.12659/MSM.882033

Available online: 2011-10-26

Published: 2011-10-26

Background:    An 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/Methods:    Dose-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.
    Results:    Total 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).
    Conclusions:    Tthe 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.

Keywords: Middle Aged, Male, Humans, Fluoroscopy - adverse effects, Female, Blood Vessel Prosthesis Implantation - methods, Aortic Aneurysm, Abdominal - surgery, Angiography, Digital Subtraction - adverse effects, Aged, 80 and over, Aged, Adult, Radiation Dosage, Radiography, Interventional - adverse effects, Statistics, Nonparametric, Time Factors