Comparison of local radiation dose to national diagnostic reference levels for endovascular aortic aneurysm repair

Abstract

Introduction: hybrid rooms (HR) provide advanced imaging capabilities within an optimal open surgical environment. The technology associated with hybrid rooms facilitates endovascular navigation and enhances technical success during endograft implantation and other endovascular procedures. However, radiation exposure remains a significant concern. Objective: this study aims to compare the recommended national Diagnostic Reference Levels (DRLs) with the local DRLs of a tertiary hospital. Material and methods: a retrospective study was conducted on patients undergoing endovascular aortic repair (EVAR) from January 2016 to September 2022. Patient demographics, radiation dose, type of C-arm, and contrast use were analyzed. Results: a total of 245 patients were included: 136 in the MCA group (Group 1) and 109 in the HR group (Group 2). Patients in Group 2 received double the mean kerma air product compared to Group 1 (112.29 Gy·cm² vs. 53.8 Gy·cm², p < 0.001), as well as a higher cumulative air kerma (361.11 mGy vs. 221.40 mGy, p < 0.001) and greater contrast volume (71.45 mL vs. 64.71 mL, p = 0.039). Conclusions: patients undergoing EVAR in the HR with fixed imaging received higher KAP and contrast doses compared to those treated with a mobile C-arm. However, radiation exposure and contrast usage remained below national Diagnostic Reference Levels.