Patient radiation exposure during carotid artery stenting

Objectives: The main purpose of this study was to document the radiation doses to patients during carotid stenting.

Material and method: Fluoroscopy and exposure time, air kerma and dose-area product during carotid artery stenting in 160 patients were retrospectively reviewed with regard to body mass index, degree of stenosis and use of cerebral protection devices.

Results: Total air kerma was lower than 0.5 Gy in 80%, 0.5-1 Gy in 17% and higher than 1 Gy (maximum 1.2) in 3% of patients. Mean total dose-area product value for carotid stenting was 54 Gy cm(2). The mean air kerma (fluoroscopy), air kerma (exposure), total air kerma and dose-area product (fluoroscopy), dose-area product (exposure), total dose-area product of patients with body mass index within the range 25-29.9 and with body mass index >30 were significantly increased compared to that of patients with body mass index 18-24.9 (H = 40.2, df = 2; p = 0.0000001 and p = 0.000003, respectively).

Conclusion: Carotid artery stenting is a relatively safe radiological procedure in terms of the radiation dose acquired by the patient. The main factors contributing to possible radiation overdosing are body mass index value and complexity of the carotid lesion. Proper preoperative planning in obese and complicated patients may reduce the fluoroscopy time and contribute to reduced dose acquisition.