Publicação
Impact of patient anatomy on radiation dose during endovascular repair of abdominal aortic aneurysms
| Resumo: | Abstract Introduction: Endovascular aortic aneurysm repair (EVAR) has increasingly become the mainstream treatment of abdominal aortic aneurysms. However, because it requires ionising radiation, concerns about both patient and surgeon exposure have been raised. Methods: A retrospective analysis was conducted to evaluate all patients who underwent standard infra-renal endovascular aneurysm repair (EVAR) using aorto-bi-iliac endoprosthesis for infrarenal abdominal aortic aneurysms (AAA) from January 2018 to December 2022. All procedures were performed using the Ziehm Vision RFD mobile C-arm system (Ziehm Imaging, Nuremberg, Germany). The primary endpoint was to determine whether the Body Mass Index (BMI) was an independent predictor of intraoperative radiation exposure during EVAR procedures. Results: A total of 91 patients had recorded Dose Area Product (DAP) information. Of these, 76 had recorded height and weight for BMI calculation and were included in this study. The mean age was 73.5±8.3 years, and most patients were 72 male (94.7%). The mean BMI was 27.2±4.0 kg/m2, with 41% of patients classified as overweight and 22% as obese. Median DAP was 77.9 Gy.cm2 (inter-quartile range 51-123). DAP did not differ between sexes. A higher BMI category was associated with higher DAP values (p = 0.008). Higher DAP was also related to general anaesthesia (p=0.002) and intra-operative complications (p = 0.031). In multiple linear regression, BMI remained an independent predictor of higher DAP, with each additional kg/m2 of BMI increasing DAP by 5.15 Gy.cm2 (p = 0.010). Conclusion: Higher BMI is associated with a higher radiation dose in standard EVAR procedures, which may be relevant when reducing both patients’ and professionals’ radiation exposure. |
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| Autores principais: | Dias,Lara R. |
| Outros Autores: | Nóbrega,Leandro; Costa-Pereira,Tiago; Piedade,Rita; Soares,Margaret; Mansilha,Armando |
| Assunto: | Radiation dosage Abdominal Aorta, Aneurysm Endovascular Obesity |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Fundação para a Ciência e Tecnologia |
| Idioma: | inglês |
| Origem: | SciELO Portugal |
| Resumo: | Abstract Introduction: Endovascular aortic aneurysm repair (EVAR) has increasingly become the mainstream treatment of abdominal aortic aneurysms. However, because it requires ionising radiation, concerns about both patient and surgeon exposure have been raised. Methods: A retrospective analysis was conducted to evaluate all patients who underwent standard infra-renal endovascular aneurysm repair (EVAR) using aorto-bi-iliac endoprosthesis for infrarenal abdominal aortic aneurysms (AAA) from January 2018 to December 2022. All procedures were performed using the Ziehm Vision RFD mobile C-arm system (Ziehm Imaging, Nuremberg, Germany). The primary endpoint was to determine whether the Body Mass Index (BMI) was an independent predictor of intraoperative radiation exposure during EVAR procedures. Results: A total of 91 patients had recorded Dose Area Product (DAP) information. Of these, 76 had recorded height and weight for BMI calculation and were included in this study. The mean age was 73.5±8.3 years, and most patients were 72 male (94.7%). The mean BMI was 27.2±4.0 kg/m2, with 41% of patients classified as overweight and 22% as obese. Median DAP was 77.9 Gy.cm2 (inter-quartile range 51-123). DAP did not differ between sexes. A higher BMI category was associated with higher DAP values (p = 0.008). Higher DAP was also related to general anaesthesia (p=0.002) and intra-operative complications (p = 0.031). In multiple linear regression, BMI remained an independent predictor of higher DAP, with each additional kg/m2 of BMI increasing DAP by 5.15 Gy.cm2 (p = 0.010). Conclusion: Higher BMI is associated with a higher radiation dose in standard EVAR procedures, which may be relevant when reducing both patients’ and professionals’ radiation exposure. |
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