Comparison of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease with Flat-Panel Detectors on Mobile C-arm versus Fixed Systems

Ann Vasc Surg. 2018 Feb:47:104-113. doi: 10.1016/j.avsg.2017.08.036. Epub 2017 Sep 8.

Abstract

Background: Flat-panel detectors on mobile C-arm (MC-arm) systems are currently challenging fixed C-arm (FC-arm) systems used in hybrid operating rooms. MC-arm systems offer an alternative to FC-arm systems in the endovascular treatment of peripheral arterial disease (PAD) but their efficiency has not been evaluated comparatively.

Methods: Two series of patients undergoing arteriography with intention to treat were included. Each series consisted of 2 nonrandomized groups: an MC-arm group and an FC-arm group. Series 1 evaluated exposure to the patient (MC-arm, n = 113; FC-arm, n = 206) while series 2 evaluated exposure to patients and also health care personnel (MC-arm, n = 24; FC-arm, n = 76). The primary end points for evaluating exposure were air kerma (AK, in mGy) for patients and effective dose for health care personnel (in μSv).

Results: After adjustment for the effect of body mass index (analysis of covariance test), AK was found to be lower in the MC-arm group than in the FC-arm group (124.1 ± 142 vs. 173.3 ± 248.7, P = 0.025). There was no difference between the groups with regard to effective dose recorded for senior surgeons or for operating room nurses. However, a higher effective dose was recorded by the MC-arm group external dosimeter for the trainee resident and for nurse anesthetists.

Conclusions: In endovascular treatment of lower limb PAD, use of an FC-arm system is associated with more radiation exposure to the patient than an MC-arm system. However, this type of imaging system does not appear to affect exposure to health care personnel.

Publication types

  • Comparative Study

MeSH terms

  • Angiography / instrumentation*
  • Endovascular Procedures*
  • Equipment Design
  • Fluoroscopy / instrumentation
  • Humans
  • Lower Extremity / blood supply
  • Lower Extremity / surgery
  • Occupational Exposure / analysis*
  • Operating Rooms
  • Peripheral Arterial Disease / surgery*
  • Personnel, Hospital
  • Prospective Studies
  • Radiation Dosage*
  • Radiation Exposure / analysis*
  • Radiography, Interventional / instrumentation*
  • Retrospective Studies