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Publications

Journal Article Epublish 1 citation

PubMed: 38535106 DOI: 10.3390/jcdd11030083

Radiation Exposure and Contrast Agent Use during Endovascular Aortic Repair Using Mobile Versus Fixed Angiography Systems.

J Cardiovasc Dev Dis 11(3)

Authors: Amir Arnautovic, Waseem Garabet, Reinhold Thomas Ziegler, Joscha Mulorz, Sönke Maximilian Braß, Alexander Oberhuber, Hubert Schelzig, Markus Udo Wagenhäuser, Philip Dueppers

Affiliations

  • Clinic for Vascular and Endovascular Surgery, Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany.
  • Clinic for Vascular and Endovascular Surgery, Department of Vascular and Endovascular Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
  • Clinic for Vascular Surgery, Department of Vascular Surgery, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

Abstract

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 ( = 20); HOR ( = 30)) and 43 TEVAR (SOR ( = 22); HOR (= 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; EVAR, HOR: 7819 ± 8928 cGy·cm; TEVAR, SOR: 8963 ± 34,458 cGy·cm; TEVAR, HOR: 14,591 ± 11,584 cGy·cm ( < 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 ( < 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 ( < 0.05); TEVAR; SOR: 71.5 ± 53.4 mL, TEVAR, HOR: 48.2 ± 27.5 mL ( ≥ 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.

MeSH

Contrast Media, Aortic Aneurysm, Operating Rooms, Fluoroscopy, Angiography, Radiation Exposure, Endovascular Aneurysm Repair