1Bar Velan,1Yvonne Tsitsiou, 1Yvonne Tsitsiou, 1Sophie Peregrine, 2Rishabh Gupta, 1Rishabh Gupta, 1Mohamad Hamady
1Imperial College Healthcare NHS Trust, 2Imperial College London
To assess current practice in standard and complex endovascular aortic repair (EAR) and formulate local guidelines to improve radiation protection for operators and patients.
Material(s) and Method(s):
Data was collected from PACS and electronic patient records for all patients undergoing EAR over a period of 2 years. Procedure details included; complexity, theatre time, fluoroscopy time, radiation dose, machine information and operator were collected and analysed using Microsoft Excel sheets and IBM SPSS Statistics 27. Normality tests were carried out and Kruska-Wallis Tests were used to compare non-parametric data.
Median fluoroscopy times of EVAR, TEVAR and Complex procedures were 18:58, 11:12 and 44:23 (mm:ss) and dose of 44.75, 69.81 and 109.5mGycm2, respectively.
Based on machine types, the radiation doses were A) 91.7mGycm2, B) 63.8mGycm2 and C) portable C-arm 20.2mGycm2 (p=0.004). Complex procedure doses were A) 179mGycm2, B)103.29mGycm2 and C) portable C-arm 25.35mGycm2 (p=0.041) respectively.
There was also inter-operator differences in fluoroscopy time during EVAR procedures (p=0.008) as well as time and doses during complex procedures (p=0.013 and p=0.03 respectively).
TEVAR and complex procedures were associated with higher radiation doses and fluoroscopy time. Significant variations were observed in relation to machine type and inter-operator parameters. Recommendations to refine performance and machine settings will be discussed.