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

Majewska N, Stanisic MG, Blaszak MA, Juszkat R, Frankiewicz M, Krasinski Z, Makalowski M, Majewski W - Med. Sci. Monit. (2011)

Bottom Line: 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.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).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Poznan University of Medical Sciences, Poznan, Poland.

ABSTRACT

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: The 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.

Show MeSH

Related in: MedlinePlus

Digital subtraction angiography (A) before and (B) after abdominal stent-graft implantation, (C) 3D computer tomography images of implanted stent-graft, (D) tortuosity of iliac arteries over 45°, (E) tortuosity of iliac arteries less than 45° and (F) long and short aneurysm necks.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3539495&req=5

f1-medscimonit-17-11-mt97: Digital subtraction angiography (A) before and (B) after abdominal stent-graft implantation, (C) 3D computer tomography images of implanted stent-graft, (D) tortuosity of iliac arteries over 45°, (E) tortuosity of iliac arteries less than 45° and (F) long and short aneurysm necks.

Mentions: In this study, necks measuring 8–15 mm were considered short, and those measuring more than 15 mm were categorized as long. Neck angle, defined by the angle formed between the flow axes of the neck and body of the aneurysm, should not measure more than 60°. Three groups of neck angles according to the difficulty in proper positioning of the proximal part of stent-grafts (<30°, 30–44° and 45–60°) have been established and these were used in the present study [13,14]. Moreover, according to the level of difficulty in deployment of distal parts of stent-grafts, patients were divided into 2 groups: 1 having iliac arteries bent less than 45° and the other with curvatures of 45° or more (Figure 1). Patients were also divided into 3 groups with regards to BMI. The body mass index (BMI) (weight [kg]/height squared [cm]) was obtained for each patient to analyze radiation dose variations relative to body size. The BMIs are characterized with values in the range of <18.5 to >30 and can be divided into 4 categories: underweight (<18.5), normal weight (18.5–24.9), overweight (25–29.9), and obese (≥30). None of the analyzed patients were underweight.


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

Majewska N, Stanisic MG, Blaszak MA, Juszkat R, Frankiewicz M, Krasinski Z, Makalowski M, Majewski W - Med. Sci. Monit. (2011)

Digital subtraction angiography (A) before and (B) after abdominal stent-graft implantation, (C) 3D computer tomography images of implanted stent-graft, (D) tortuosity of iliac arteries over 45°, (E) tortuosity of iliac arteries less than 45° and (F) long and short aneurysm necks.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539495&req=5

f1-medscimonit-17-11-mt97: Digital subtraction angiography (A) before and (B) after abdominal stent-graft implantation, (C) 3D computer tomography images of implanted stent-graft, (D) tortuosity of iliac arteries over 45°, (E) tortuosity of iliac arteries less than 45° and (F) long and short aneurysm necks.
Mentions: In this study, necks measuring 8–15 mm were considered short, and those measuring more than 15 mm were categorized as long. Neck angle, defined by the angle formed between the flow axes of the neck and body of the aneurysm, should not measure more than 60°. Three groups of neck angles according to the difficulty in proper positioning of the proximal part of stent-grafts (<30°, 30–44° and 45–60°) have been established and these were used in the present study [13,14]. Moreover, according to the level of difficulty in deployment of distal parts of stent-grafts, patients were divided into 2 groups: 1 having iliac arteries bent less than 45° and the other with curvatures of 45° or more (Figure 1). Patients were also divided into 3 groups with regards to BMI. The body mass index (BMI) (weight [kg]/height squared [cm]) was obtained for each patient to analyze radiation dose variations relative to body size. The BMIs are characterized with values in the range of <18.5 to >30 and can be divided into 4 categories: underweight (<18.5), normal weight (18.5–24.9), overweight (25–29.9), and obese (≥30). None of the analyzed patients were underweight.

Bottom Line: 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.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).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Poznan University of Medical Sciences, Poznan, Poland.

ABSTRACT

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: The 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.

Show MeSH
Related in: MedlinePlus