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Occupational exposure during endovascular aneurysm repair (EVAR) and aortoiliac percutaneous transluminal angioplasty (PTA) procedures

Authors
  • Tzanis, Eleftherios1
  • Tsetis, Dimitrios2
  • Kehagias, Elias2
  • Ioannou, Christos V.3
  • Damilakis, John4
  • 1 University of Crete, Department of Medical Physics, Medical School, Heraklion, Crete, 71003, Greece , Heraklion, Crete (Greece)
  • 2 University of Crete, Interventional Radiology Unit, Department of Radiology, University Hospital of Heraklion, Medical School, Crete, Greece , Crete (Greece)
  • 3 University of Crete, Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, Medical School, Crete, Greece , Crete (Greece)
  • 4 University of Crete, Department of Medical Physics, University Hospital of Heraklion, Medical School, Faculty of Medicine, Iraklion, Crete, 71003, Greece , Iraklion, Crete (Greece)
Type
Published Article
Journal
La radiologia medica
Publisher
Springer Milan
Publication Date
Jan 23, 2019
Volume
124
Issue
6
Pages
539–545
Identifiers
DOI: 10.1007/s11547-018-00985-8
Source
Springer Nature
Keywords
License
Yellow

Abstract

ObjectivesThe purpose of this study was to determine the radiation exposure of primary interventionalist’s different body parts during endovascular aneurysm repair (EVAR) procedures and aortoiliac percutaneous transluminal angioplasty (PTA) procedures and to evaluate the efficacy of a radioprotective drape.MethodsOccupational doses for 36 consecutive aortoiliac PTA procedures and 17 consecutive EVAR procedures were estimated using thermoluminescence dosimetry (TLD) chips (TLD-200, Hashaw, Solon, OH). Effective dose (ED) was calculated using the Niklason algorithm. For the evaluation of a 0.25 mm Pb equivalent drape (Ecolab, Saint Paul, Minnesota, USA), experiments were performed using two physical anthropomorphic phantoms (Rando-Alderson Research Labs, CA, USA).ResultsMedian ED for a typical EVAR and PTA procedure was 4.7 ± 1.4 μSv and 4.4 ± 3.6 μSv, respectively. The highest radiation doses were measured for the operator’s hands in both procedures. Moreover, considerable doses were measured to the operator’s head, eye lenses and thyroid. Due to the use of the drape, radiation exposure of primary operator’s abdominal area, genitals, thyroid and eye lenses was reduced by an average of 59%, 60%, 65% and 59%, respectively. However, dose area product (DAP) and peak skin dose (PSD) were increased by 20% when part of the drape was placed into the X-ray field.ConclusionDuring EVAR and PTA procedures, primary operator’s organs are exposed to considerable radiation doses. Occupational radiation exposure can be reduced significantly with the proper use of a radioprotective drape.

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