Surgeon Education Decreases Radiation Dose In Complex Endovascular Procedures And Improves Patient Safety

At a glance

Type of study

Original research, Retrospective cohort study

Who was studied

Vascular surgeons, Patients

Size

n = 300 procedures

Topics

Training and educationDose reduction techniquesPatient doseDosimetry and monitoring

Summary based on

the abstract

What it found

• After surgeon education, the dose index (PSD/RAK ratio) fell, giving an estimated 16% reduction in peak skin dose.

  Key figures: 1.14 to 0.79 (P < .0001); 16% reduction in PSD

• Education most strongly changed table height, which rose by an average of 10 cm per case.

  Key figures: 10 cm per case (P < .0001)

• Collimation use increased after education, but this did not lower peak skin dose.

  Key figures: 25% to 40% (P < .001)

• FEVAR made up most high-dose cases and had significantly higher median RAK than other procedures.

  Key figures: 70% of investigated cases; P < .0001

• The total number of cases over 6 Gy RAK did not change, but the proportion of non-FEVAR cases over 6 Gy halved.

  Key figures: 40% to 20%

Limits to keep in mind

Single-centre before-after comparison with no control group, and only 300 of 447 procedures had sufficient data (PSD for 122). Outcomes are patient dose metrics; staff occupational dose was not measured.

Related research summaries

• Radiation Awareness for EVAR in Hybrid Operating Room: An Instant Operator Risk Chart (2021, Dosimetry measurement study)
• ICRP Publication 117. Radiological Protection In Fluoroscopically Guided Procedures Performed Outside The Imaging Department (2010, Guideline or consensus statement)
• ICRP Draft - Radiological Protection in Fluoroscopically Guided Procedures (Guideline or consensus statement)
• AAPM Medical Physics Practice Guideline 12.a - Fluoroscopy Dose Management (2022, Guideline or consensus statement)
• IU Health Handbook of Fluoroscopy Safety (Guideline or consensus statement)