-
Tytuł:
-
National Diagnostic Reference Levels for Endovascular Aneurysm Repair and Optimisation Strategies.
-
Autorzy:
-
Rial R; Vascular Surgery Department, University Hospital Clinico San Carlos, Madrid, Spain. Electronic address: .
Vañó E; Medical Physics Service, Hospital Clínico San Carlos and IdISSC, Madrid, Spain; Radiology Department, Complutense University, Madrid, Spain.
Del Río-Solá ML; Vascular Surgery Department, University Hospital Clinico Valladolid, Valladolid, Spain.
Fernández JM; Medical Physics Service, Hospital Clínico San Carlos and IdISSC, Madrid, Spain.
Sánchez RM; Medical Physics Service, Hospital Clínico San Carlos and IdISSC, Madrid, Spain; Radiology Department, Complutense University, Madrid, Spain.
Camblor Santervás LA; Vascular Surgery Department, Asturias Central Universitery Hospital, Oviedo, Spain.
Bellmunt S; Vascular Surgery Department, University Hospital Vall D'hebron, Barcelona, Spain.
Blanco E; Vascular Surgery Department, Guadalajara University Hospital, Guadalajara, Spain.
El Amrani Joutey M; Vascular Surgery Department, University Hospital Ramon y Cajal, Madrid, Spain.
González Cañas E; Vascular Surgery Department, University Hospital Parc Tauli, Sabadell, Spain.
Gomez Palones FJ; Head of Vascular Surgery, Vascular Surgery Department, University Hospital Dr. Peset, Valencia, Spain.
González Fajardo JA; Vascular Surgery Department, University Hospital 12 Octubre, Madrid, Spain.
González Tabares E; University Hospital of Canarias, Tenerife, Spain.
Llagostera Pujol S; Vascular Surgery Department, University Hospital German Trias y Pujol, Badalona, Spain.
Rielo Arias F; Vascular Surgery Department, University Hospital Lucus Augusti, Lugo, Spain.
Salmerón Febres LM; Vascular Surgery Department, University Hospital, San Cecilio, Granada, Spain.
Aramendi Arieta-Araunabeña C; Vascular Surgery Department, Basurto Hospital, Bilbao, Spain.
Iborra Ortega E; Vascular Surgery Department, University Hospital Bellvitge, L'Hospitalet de Llobregat, Spain.
Guerra Requena M; Vascular Surgery Department, Guadalajara University Hospital, Guadalajara, Spain.
-
Źródło:
-
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery [Eur J Vasc Endovasc Surg] 2020 Dec; Vol. 60 (6), pp. 837-842. Date of Electronic Publication: 2020 Sep 08.
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Publication: 2002-: London : Elsevier
Original Publication: London, UK : W.B. Saunders Co. Ltd., c1995-
-
MeSH Terms:
-
Endovascular Procedures*
Reference Standards*
Aneurysm/*diagnostic imaging
Fluoroscopy/*standards
Radiation Exposure/*standards
Aged ; Aged, 80 and over ; Aneurysm/surgery ; Fluoroscopy/instrumentation ; Humans ; Middle Aged ; Patient Safety ; Point-of-Care Systems/standards ; Radiation Exposure/prevention & control ; Radiometry ; Spain
-
Contributed Indexing:
-
Keywords: DRLs; EVAR; European directive; Optimisation; Patient dose
-
Entry Date(s):
-
Date Created: 20200911 Date Completed: 20210209 Latest Revision: 20210209
-
Update Code:
-
20240105
-
DOI:
-
10.1016/j.ejvs.2020.08.006
-
PMID:
-
32912764
-
Objective: The International Commission on Radiological Protection (ICRP) has highlighted the large number of medical specialties using fluoroscopy outside imaging departments without programmes of radiation protection (RP) for patients and staff. Vascular surgery is one of these specialties and endovascular aneurysm repair (EVAR) is one of the most challenging procedures requiring RP guidance and optimisation actions. The recent European Directive on Basic Safety Standards requires the use and regular update of diagnostic reference levels (DRL) for interventional procedures. The objective of the study was to know the doses of patients undergoing EVAR with mobile Xray systems and with hybrid rooms (fixed Xray systems), to obtain national DRLs and suggest optimisation actions.
Methods: The Spanish Chapter of Endovascular Surgery launched a national survey that involved hospitals for 10 autonomous communities representing the 77% of the Spanish population (46.7 million inhabitants). Patient dose values from mobile Xray systems were available from nine hospitals (sample of 165 EVAR procedures) and data from hybrid rooms, from seven hospitals, with dosimetric data from 123 procedures. The initial national DRLs have been obtained, as the third quartile of the median values from the different centres involved in the survey.
Results: The proposed national DRLs are 278 Gy cm 2 for hybrid rooms and 87 Gy cm 2 for mobile Xray systems, and for cumulative air kerma (cumulative AK) at the patient entrance reference point, 1403 mGy for hybrid rooms, and 292 mGy for mobile systems.
Conclusion: An audit of patient doses for EVAR procedures to identify optimised imaging protocol strategies is needed. It is also appropriate to evaluate the diagnostic information required for EVAR procedures. The increase by a factor of 3.2 (for kerma area product) and 4.8 (for cumulative AK) in the DRLs needs to be justified when the procedures are performed in the hybrid rooms rather than with mobile Xray systems.
(Copyright © 2020 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)
