Comparison of Patient Radiation Dose and Contrast Use during EVAR in a Dedicated Hybrid Vascular OR and Mobile Imaging
Zia Ur Rehmana b c✉, Sohail A. Choksya, Adam Howarda, Justin Carterd, Konstatinos Kyriakidisa, Dean Elizabetha, Farthing Mathewa
- aDepartment of Vascular Surgery, Colchester University Hospital, Colchester, Essex, UK
- bSection of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. Electronic address: ziaur.rehman@aku.edu
- cSection of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
- dDepartment of Radiology, Colchester University Hospital, Colchester, Essex, UK
- ✉Corresponding author
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Abstract
OBJECTIVE The aim of the study is to determine whether performing EVAR in a dedicated vascular hybrid OR is associated with a decreased patient radiation and contrast dose compared to mobile C arm imaging in a conventional OR. METHODOLOGY This is a retrospective study of patients undergoing standard EVAR from 2009-2016. 'Standard EVAR' was defined as the elective EVAR performed with bifurcated graft for infrarenal aneurysm with no iliac aneurysms. Patients were divided into two groups. Group 1 included EVARs performed in conventional theatre with a mobile C arm (Jan 2009 to June 2012) and group 2 EVARs performed in the dedicated vascular hybrid OR (July 2012 to Dec 2016). Data collected included patient demographics, aneurysm diameter, neck length, radiation dose, screening time and contrast use for each patient. RESULTS There were 286 patients, 78 and 208 patients in Group 1 and 2 respectively. There was no difference in age [77.6 years (76.3-78.9) vs. 76.6 years (75.9-77.9), P>0.05)], BMI [26.5 kg/m2 [(25.1-28.0) vs. 27.9 kg/m2 (27.1-28.7) P>0.05] and mean aneurysm diameter [6.48 cms (6.13-6.82) vs. 6.81 cms (6.0-7.7), P>0.05] between groups. Patients in Group 2 received approximately half the mean radiation dose [16807 cGy.cm2 (±11078) vs. 8233 cGy.cm2 (±7471), P<0.001), shorter fluoroscopy time [36.02 min (± 21.3) vs. 26.96 min (± 19), P=0.001] and less contrast use 114 mls (± 44.2) vs. 158 mls (± 63.9), P<0.001]. CONCLUSION Performing EVAR in a dedicated vascular Hybrid OR may be associated with a lower patient radiation dose, shorter screening time and less contrast use compared to performing EVAR in a conventional OR.
TL;DRPerforming EVAR in a dedicated vascular hybrid OR may be associated with a lower patient radiation dose, shorter screening time and less contrast use compared to performing EVar in a conventional OR. (Semantic Scholar)